Coinfection of Japanese Encephalitis with Neurocysticercosis: An Imaging Study

Handique, Sanjeev K.; Das, Ritu; Saharia, B.; Das, Pankaj; Buragohain, R.; Saikia, Projnan

doi:10.3174/ajnr.a0769

Cited by 28 publications

(18 citation statements)

References 20 publications

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“…This out numbers the prevalence of coinfection with NCC in adult age group as seen in other studies. (24) Intensity of lesions in the Thalamus was seen more on the side of neurocysticerci (Fig: 1 A-D)as that seen in Handique et al, and Singh P et al, (24,25) Asymmetry of the JE lesions were noted similar to other studies done in adult population. (24,25) This supports the possibility of facilitation of JE infection or neurotropic viral infection by this larval infestation even in children.…”

Section: Discussionsupporting

confidence: 81%

MR Imaging Spectrum of Japanese B Encephalitis in Pediatric Age Group

Borah¹,

Dhingani²,

Gogoi³

2015

jemds

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BACKGROUND: Japanese B encephalitis is an important public health problem, mainly in the districts of upper Assam. MRI Brain with its conventional T2/FLAIR sequences as well as DWI & ADC mapping can clearly depict the site & extent of involvement of different parts of the brain along with any associated coinfections. Especially DWI sequence shows findings that closely follows the pathological changes of the encephalitic process. OBJECTIVE: To evaluate Japanese B encephalitis in pediatric age group with MRI Brain. METHODS: It is a retrospective descriptive observational study carried out on AES cases referred to our department from Pediatric department for MRI Brain during January-September 2015. All cases were evaluated as per following protocol. Axial T1-weighted (T1-W) & T2-weighted (T2-W), axial & coronal fluid-attenuated inversion recovery pulse image (FLAIR), axial GRE/SWI and axial Diffusion-weighted imaging (DWI) with ADC (Apparent diffusion coefficient) sequences were taken. In cases where contrast study was indicated, post contrast T1-W fat saturated (T1FS) sequence in axial, coronal and saggital planes were taken. Serological tests, i.e., MAC ELISA and VNT, for the diagnosis of JE were done by using paired blood & CSF samples. RESULTS: Out of the 24 cases referred for MRI evaluation, JE was confirmed serologically in 21 patients. Most of the cases showed symmetrical T2/FLAIR hyperintensity in bilateral Thalami & Substantia nigra. CONCLUSION: Japanese B Encephalitis is the most common & important cause of AES in this region of Upper Assam, especially in pediatric age group mainly in the rainy season. MRI could detect the disease process as efficiently as that of serological and CSF studies along with its coinfections.

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Section: Discussionsupporting

confidence: 81%

MR Imaging Spectrum of Japanese B Encephalitis in Pediatric Age Group

Borah¹,

Dhingani²,

Gogoi³

2015

jemds

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“…For example, studies were conducted on patients with Japanese encephalitis (JE) [42], a simple random sample of people living in a community in Mexico [19], patients attending imaging diagnostic centers [11], [32] and children with partial seizures [13]–[14], [31]. The frequency of NCC across these populations varied widely and the heterogeneity between studies hindered the calculation of an overall estimate.…”

Section: Discussionmentioning

confidence: 99%

A Systematic Review of the Frequency of Neurocyticercosis with a Focus on People with Epilepsy

et al. 2010

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BackgroundThe objective of this study is to conduct a systematic review of studies reporting the frequency of neurocysticercosis (NCC) worldwide.Methods/Principal FindingsPubMed, Commonwealth Agricultural Bureau (CAB) abstracts and 23 international databases were systematically searched for articles published from January 1, 1990 to June 1, 2008. Articles were evaluated for inclusion by at least two researchers focusing on study design and methods. Data were extracted independently using standardized forms. A random-effects binomial model was used to estimate the proportion of NCC among people with epilepsy (PWE). Overall, 565 articles were retrieved and 290 (51%) selected for further analysis. After a second analytic phase, only 4.5% of articles, all of which used neuroimaging for the diagnosis of NCC, were reviewed. Only two studies, both from the US, estimated an incidence rate of NCC using hospital discharge data. The prevalence of NCC in a random sample of village residents was reported from one study where 9.1% of the population harboured brain lesions of NCC. The proportion of NCC among different study populations varied widely. However, the proportion of NCC in PWE was a lot more consistent. The pooled estimate for this population was 29.0% (95%CI: 22.9%–35.5%). These results were not sensitive to the inclusion or exclusion of any particular study.Conclusion/SignificanceOnly one study has estimated the prevalence of NCC in a random sample of all residents. Hence, the prevalence of NCC worldwide remains unknown. However, the pooled estimate for the proportion of NCC among PWE was very robust and could be used, in conjunction with estimates of the prevalence and incidence of epilepsy, to estimate this component of the burden of NCC in endemic areas. The previously recommended guidelines for the diagnostic process and for declaring NCC an international reportable disease would improve the knowledge on the global frequency of NCC.

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“…[ 5 ] It has been postulated that co-infection of JE and NCC might be synergistic and not simply a coincidence. [ 6 ] In patients with NCC, there might be an altered immune response and facilitated invasiveness of JE virus. [ 7 ]…”

Section: Discussionmentioning

confidence: 99%

A tropical menace of co-infection of Japanese encephalitis and neurocysticercosis in two children

et al. 2016

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Japanese encephalitis (JE) is a mosquito borne encephalitis caused by Flavivirus. Neurocysticercosis (NCC) is a parasitic disease of the central nervous system caused by Taenia solium. In this report, we describe the clinical profile, imaging findings, and outcome of two children with JE and coexisting NCC. Eleven and thirteen-year-old boys from the same town of Jharkhand state were brought with history of fever, seizures, altered sensorium, and extrapyramidal symptoms. Dystonia, hypomimia, bradykinesia, and dyskinesia were observed. Meige syndrome observed in one of the children is a novel finding. Magnetic resonance imaging of the brain revealed findings suggestive of JE with cysticercal granulomas. There are few reports of coexistence of JE and NCC in children. Both children were treated with ribavirin, and follow-up imaging had shown significant resolution of signal changes. Both the children had shown marked clinical improvement. Ribavirin was found to beneficial in reducing the morbidity in our patients.

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Coinfection of Japanese Encephalitis with Neurocysticercosis: An Imaging Study

Cited by 28 publications

References 20 publications

MR Imaging Spectrum of Japanese B Encephalitis in Pediatric Age Group

MR Imaging Spectrum of Japanese B Encephalitis in Pediatric Age Group

A Systematic Review of the Frequency of Neurocyticercosis with a Focus on People with Epilepsy

A tropical menace of co-infection of Japanese encephalitis and neurocysticercosis in two children

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