Clinical and radiological spectrum of Japanese encephalitis

Basumatary, Lakshya J; Raja, Dina; Bhuyan, Dipu; Das, Manas; Goswami, Munindra; Kayal, Ashok K

doi:10.1016/j.jns.2012.11.007

Cited by 59 publications

(64 citation statements)

References 20 publications

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“…Kalita et al [11] in their study on Japanese encephalitis of 67 patients had found dystonia to be commoner in children (<15 years of age) (20 patients 66.7%) compared to adults (>15 years of age) (seven patients 18.6%). Basumatary et al [12] in their study of 148 Japanese encephalitis patients had also found dystonia to be commoner in children (<14 years of age) (19 patients 43.1%) compared to adults (>14 years of age) (19 patients 18.2%). In our study on MRI, signal changes were seen in the thalamus in three (75%) out of the four patients with dystonia in the age group <6 years compared to the other groups in which thalamus was involved in three (25%) out of the 12 patients with dystonia in >6 to <25 years and not involved in >25 years of age patients.…”

Section: Discussionmentioning

confidence: 99%

Movement disorders of probable infectious origin

Jhunjhunwala

Netravathi

Pal

2014

Ann Indian Acad Neurol

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Background:Movement disorders (MDs) associated with infections remains an important debilitating disorder in the Asian countries.Objectives:The objective of the following study is to report the clinical and imaging profile of a large cohort of patients with MDs probably associated with infection.Materials and Methods:This was a chart review of 35 patients (F:M-15:20) presenting with MD in the Neurology services of National Institute of Mental Health and Neurosciences, India. The demographic profile, type of infection, time from infection to MD, phenomenology of MD and magnetic resonance imaging (MRI) findings were reviewed.Results:The mean age at presentation was 22.6 ± 13.3 years, (5-60), age of onset of MD was 15.7 ± 15 years, and duration of symptoms was 6.9 ± 8.1 years (42 days to 32 years). The mean latency of onset of MD after the infection was 5.9 ± 4.2 weeks. The phenomenology of MD were: (1) Pure dystonia-28.6%, (2) dystonia with choreoathetosis-22.9%, (3) Parkinsonism-14.6%, (4) pure tremor, hemiballismus, myoclonus and chorea-2.9% each, and (5) mixed MD-22.9%. Most often the MD was generalized (60%), followed by right upper limb (31.4%) and left upper limb (8.6%). A viral encephalitic type of neuroinfection was the most common infection (85.7%), which was associated with MD. Abnormalities of brain MRI, seen in 79.2%, included signal changes in (1) thalamus-52.0%, (2) putamen and subcortical white matter-16% each, (3) pons-12%, (4) striatopallidum, striatum and grey matter-8% each, and (5) caudate, cerebellum, lentiform nucleus, midbrain and subthalamic nucleus-4.0% each.Conclusions:MDs associated with infection were the most often post-encephalitic. Dystonia was the most common MD, and thalamus was the most common anatomical site involved.

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Section: Discussionmentioning

confidence: 99%

Movement disorders of probable infectious origin

Jhunjhunwala

Netravathi

Pal

2014

Ann Indian Acad Neurol

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“…Parkinsonism is one of the most common symptoms of JE patients, being present in as many as 45% of cases (1). Brain computed tomography (CT) and MRI studies often reveal lesions in the thalamus, basal ganglia, and midbrain (4).…”

Section: Discussionmentioning

confidence: 99%

“…Approximately 15% of JE patients die during the acute phase of the illness, and most survivors present with neurological aftereffects, including striatal dysfunctions and parkinsonian features (1). Presynaptic striatal dysfunctions recently became detectable by dopamine transporter (DAT) imaging, which is usually applied to neurodegenerative disorders such as Parkinson's disease and progressive supranuclear palsy (PSP).…”

Section: Introductionmentioning

confidence: 99%

A Japanese Encephalitis Patient Presenting with Parkinsonism with Corresponding Laterality of Magnetic Resonance and Dopamine Transporter Imaging Findings

et al. 2018

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Japanese encephalitis (JE) survivors often present with nigrostriatal aftereffects with parkinsonian features. A 67-year-old woman with JE showed right-dominant clinical parkinsonism and left-dominant substantia nigra lesions after magnetic resonance imaging (MRI). Dopamine transporter (DAT) imaging using 123I-labeled 2β-carbomethoxy-3β-(4-iodophenyl)-N-(3-fluoropropyl)-nortropane (123I-FP-CIT) revealed a corresponding left-dominant decrease. The present case is the first to reveal a clear match of laterality between clinical parkinsonism, MRI-based substantia nigra lesions, and impaired DAT in presynaptic dopaminergic neurons in JE.

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“…The clinical outcome was graded by using the Glasgow outcome scale [19][20][21] at the end of the 1st and 12th month after the onset of disease: one for death, two for neurovegetative state, three for severe disability incompatible with independent living, four for moderate disability but compatible with independence, and five for full recovery.…”

Section: Clinical Outcome Assessmentmentioning

confidence: 99%