Comparison of Magnetic Resonance Imaging Abnormalities in Japanese Encephalitis and Acute Necrotizing Encephalopathy of Childhood

Wang, Huei-Shyong

doi:10.1001/archneur.61.7.1149

Cited by 6 publications

(6 citation statements)

References 11 publications

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“…As a distinctive clinical presentation of JE, parkinsonism resulting from extrapyramidal involvement, with mask-like facies, tremor, cogwheel rigidity, and choreoathetoid movements reported in child JE cases [42,43]. Encephalopathy/delirium are also frequently present in childhood JE cases PLOS NEGLECTED TROPICAL DISEASES [44]. Additionally, in the present study of adult JE cases, stroke was among the most common neurological disorders after JE diagnosis over the study observation period.…”

Section: Neurological Complications Following Je Diagnosissupporting

confidence: 47%

Long-term neurological and healthcare burden of adults with Japanese encephalitis: A nationwide study 2000-2015

Chen

Hsieh

et al. 2021

PLoS Negl Trop Dis

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Objective To assess the healthcare utilization, economic burden, and long-term neurological complications and mortality of an adult population with Japanese encephalitis (JE). Methods This study utilized two nationwide datasets in Taiwan: the Notifiable Disease Dataset of confirmed cases from the Centers for Disease Control to identify JE patients, and the National Health Insurance Research Database to obtain patients’ healthcare utilization. Survival analyses were performed to identify prognostic factors associated with the all-cause mortality of patients. Results This study included 352 adult cases with JE (aged≥20 years). The mean age of JE patients was 45 years. Stroke (event rate: 3.49/100 person-years) was the most common neurological complication, followed by epilepsy/convulsions (3.13/100 person-years), encephalopathy/delirium (2.20/100 person-years), and parkinsonism (1.97/100 person-years). Among the 336 hospitalized patients at JE diagnosis, 58.33% required intensive care. Among 79 patients who died following JE diagnosis, 48.84% of death events occurred within the year of diagnosis. The medical costs increased considerably at JE diagnosis and subsequent-year costs remained significantly higher than the costs before diagnosis (p<0.05). Having a four-dose JE vaccination (i.e., born after 1976) versus no JE vaccination history (i.e., born before 1963) was significantly associated with lower all-cause mortality (hazard ratio: 0.221 [95% confidence interval: 0.067, 0.725]). Comorbid diabetes and incident epilepsy/convulsion events significantly increased the mortality risk by 2.47- and 1.85-fold, respectively (p<0.05). Conclusion A considerable medical burden associated with JE was observed in affected adults, even in the years following JE diagnosis. Vaccination should be considered to prevent this sporadic, but lethal, viral infection.

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Section: Neurological Complications Following Je Diagnosissupporting

confidence: 47%

Long-term neurological and healthcare burden of adults with Japanese encephalitis: A nationwide study 2000-2015

Chen

Hsieh

et al. 2021

PLoS Negl Trop Dis

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“…A hematogenous entry of JEV in the OB would be in line with the observation that LaCrosse virus, another mosquito-borne virus, also spreads via the hematogenous route to the OB in mice and that capillaries in the OB could be hot spots for neuroinvasion [38]. Also the thalamus has already been shown to constitute an important tissue for JEV replication in the brain of mice [39], piglets [5], and macaques [40], and thalamic lesions are the most commonly described abnormality based on magnetic resonance imaging (MRI) of JEV patients [41][42][43]. Entry to the thalamus probably occurs via infection of the sensory neurons of the dorsal route ganglion which connects directly to the thalamus [23,39].…”

Section: Discussionmentioning

confidence: 54%

Efficient control of Japanese encephalitis virus in the central nervous system of infected pigs occurs in the absence of a pronounced inflammatory immune response

Redant

Favoreel

Dallmeier

et al. 2020

J Neuroinflammation

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Background Japanese encephalitis virus (JEV) is the leading cause of viral encephalitis in Asia. JEV infection of mice and humans can lead to an uncontrolled inflammatory response in the central nervous system (CNS), resulting in a detrimental outcome. Pigs act as important amplification and reservoir hosts, and JEV infection of pigs is mostly subclinical. Information on virus spread in the CNS and immune responses controlling JEV infection in the CNS of pigs, however remains scarce. Methods Nine-week-old pigs were inoculated intranasal or intradermal with a relevant dose of 105 TCID50 of JEV genotype 3 Nakayama strain. Clinical signs were assessed daily, and viral spread was followed by RT-qPCR. mRNA expression profiles were determined to study immune responses in the CNS. Results Besides a delay of 2 days to reach the peak viremia upon intranasal compared to intradermal inoculation, the overall virus spread via both inoculation routes was highly similar. JEV appearance in lymphoid and visceral organs was in line with a blood-borne JEV dissemination. JEV showed a particular tropism to the CNS but without the induction of neurological signs. JEV entry in the CNS probably occurred via different hematogenous and neuronal pathways, but replication in the brain was mostly efficiently suppressed and associated with a type I IFN-independent activation of OAS1 expression. In the olfactory bulb and thalamus, where JEV replication was not completely controlled by this mechanism, a short but strong induction of chemokine gene expression was detected. An increased IFNy expression was simultaneously observed, probably originating from infiltrating T cells, correlating with a fast suppression of JEV replication. The chemokine response was however not associated with the induction of a strong inflammatory response, nor was an induction of the NLRP3 inflammasome observed. Conclusions These findings indicate that an adequate antiviral response and an attenuated inflammatory response contribute to a favorable outcome of JEV infection in pigs and help to explain the limited neurological disease compared to other hosts. We show that the NLRP3 inflammasome, a key mediator of neurologic disease in mice, is not upregulated in pigs, further supporting its important role in JEV infections.

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“…A ENA foi descrita inicialmente em crianças japonesas sem alterações clínicas prévias, que apre s e ntavam deterioração rápida da consciência após uma infecção banal leve, sendo posteriormente detectada também em outros países do mundo ocidental 1 , 2 , 9 -1 1 . O b s e rva-se predomínio no acometimento de lactentes, na idade entre 6-18 meses, sendo característica a presença de lesões relativamente simétricas nos tálamos, região superior do tronco encefálico e cerebelo, poupando caudado e putamen [4][5][6][7][8] . O exame de RM em nossa paciente sugeriu o diagnóstico apenas no segundo episódio, que se manifestou de modo muito mais grave, com evolução fulminante.…”

Section: Discussionunclassified

“…Além disto, a maioria dos artigos publicados na literatura atual não têm efetuado estudos histológicos comprob a t ó r i o s 5 , 7 , 8 . A fisiopatologia da ENA é desconhecida, porém a maioria dos autores acredita no papel da imunomediação, havendo uma infecção viral como desencadeante 6,9 .…”

Section: Discussionunclassified

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Encefalopatia necrotizante aguda: paciente com evolução recidivante e letal

Casella

Nudelman

Felix

et al. 2007

Arq. Neuro-Psiquiatr.

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Acute necrotizing encephalopathy was initially reported in Japanese children. The rapid evolution and symmetrical brain lesions seen in the brainstem, cerebellum and specially in the thalamus characterize the disease. We studied a 7-month-old-girl, who presented with two episodes of rapid loss of consciousness and paresis without metabolic disturbances. At the first time she had a rapid improvement, but at the second episode the course was fulminant and in two days she lapsed into a clinical state of brain death. The magnetic resonance studies showed symmetrical lesions in the thalamus and additional lesions involving the brainstem and the cerebellum.

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Comparison of Magnetic Resonance Imaging Abnormalities in Japanese Encephalitis and Acute Necrotizing Encephalopathy of Childhood

Cited by 6 publications

References 11 publications

Long-term neurological and healthcare burden of adults with Japanese encephalitis: A nationwide study 2000-2015

Long-term neurological and healthcare burden of adults with Japanese encephalitis: A nationwide study 2000-2015

Efficient control of Japanese encephalitis virus in the central nervous system of infected pigs occurs in the absence of a pronounced inflammatory immune response

Encefalopatia necrotizante aguda: paciente com evolução recidivante e letal

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