Acute necrotizing encephalitis of childhood

Case contributed by Ghazale Jamalipour Soufi
Diagnosis almost certain

Presentation

Seizure and loss of consciousness, his mother had an influenza virus a few weeks ago.

Patient Data

Age: 5 years
Gender: Male

MRI demonstrating symmetrical mixed signal intensity with hemorrhage in the thalami. In addition, there are T2W/FLAIR hyperintensity in the bilateral internal and external capsules , cerebellar and bioccipital white matter. The brainstem including the midbrain and pons shows swelling and T2w/FLAIR high signal intensity.

Case Discussion

Acute necrotizing encephalitis of childhood is a rare encephalopathy and viral etiology has been proposed in some cases. Thalamic lesions may bleed. Intracranial hemorrhage and cavitation are associated with a worse prognosis.

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