Japanese encephalitis

Case contributed by Dr Pulkit Rangarh

Presentation

Patient presented with acute history of fever,altered sensorium with single episode of seizure.

Patient Data

Age: 25 yrs
Gender: Male
MRI

Hyperintense FLAIR signal and restricted diffusion in the thalamus bilaterally along with increased FLAIR signal in the substantia nigra bilaterally.

Case Discussion

Japanese encephalitis (JE) is one of the viral encephalitis, endemic in eastern parts of Uttar Pradesh, India. It is caused by the JE virus, a single-stranded RNA flavivirus. Characteristics neuroradiological findings include T2W/FLAIR hyperintense signals in the thalamus and substantia nigra bilaterally. Restricted diffusion is also noted in the affected parts of brain. Basal ganglia, pons, cerebellum, cerebral cortex and spinal cord may also be involved. The most common differentials include other viral encephalitides like arboviral diseases, dengue fever, enteroviral infections and herpes simplex. Final confirmation of the diagnosis is through detection of virus specific IgM antibodies through ELISA test done on serum or CSF.

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Case information

rID: 55290
Case created: 28th Aug 2017
Last edited: 6th Nov 2017
Inclusion in quiz mode: Included
Institution: KING GEORGE'S MEDICAL UNIVERSITY

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