Magnetic Resonance Imaging Findings in Viral Encephalitis: A Pictorial Essay

Jayaraman, Kalaivani; Rangasami, Rajeswaran; Chandrasekharan, Anupama

doi:10.4103/jnrp.jnrp_120_18

Cited by 46 publications

(32 citation statements)

References 10 publications

(7 reference statements)

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“…Additionally, there was involvement of the dorsolateral thalami that evolved over the course of her illness, which may have contributed to her level of visual impairment. This is in contrast to typical MRI changes found in HSV, which usually involve the temporal and frontal lobes . Cortical blindness associated with HSV encephalitis (HSE) in a child is unusual and to our knowledge, has only been reported in one other case in the literature .…”

Section: Answercontrasting

confidence: 63%

Sudden visual loss: A not so simplex case

2020

J Paediatrics Child Health

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Section: Answercontrasting

confidence: 63%

Sudden visual loss: A not so simplex case

2020

J Paediatrics Child Health

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“…The major criterion and ≥3 minor criteria are required to establish a diagnosis of clinical encephalitis 21 . Although MRI of the brain is a sensitive and specific imaging test in suspected encephalitis, it may be initially normal or may remain normal during the course of illness 22,23 . Imaging findings could also have been affected by the imaging technique, along with the subjective component of scan interpretation by the radiologist.…”

Section: Discussionmentioning

confidence: 99%

BK virus encephalitis and end‐stage renal disease in a child with hematopoietic stem cell transplantation

Bush

Johns

Betty

et al. 2020

Pediatric Transplantation

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BK virus encephalitis after HSCT is uncommon. Several reports of native kidney BKVN in patients with HSCT, hematologic malignancies, human immunodeficiency virus infection, and non‐renal solid organ transplantation have been described. However, an uncommon combination of BK encephalitis and ESRD of native kidneys secondary to BK virus in a child with HSCT has not been described. We report a 10‐year‐old boy who presented with a gradually rising serum creatinine during treatment for severe autoimmune hemolytic anemia, which he developed 9 months after receiving an allogeneic HSCT for aplastic anemia. There was no proteinuria or hematuria present. Serum BK virus load was 5 × 106 copies/mL. A renal biopsy showed evidence of BKVN. He developed fever, seizures, and confusion, and the (CSF) showed significant presence of the BK virus (1 × 106 copies/mL) along with biochemical evidence of viral encephalitis. Cerebrospinal fluid cultures were negative. Despite significant clinical symptoms and presence of BK virus in CSF, the magnetic resonance brain imaging findings were minimal. With reduction of immunosuppression, there was resolution of BK encephalitis but BKVN remained resistant to multiple anti‐BK virus agents, including leflunomide and cidofovir. He eventually became dialysis‐dependent and, 6 years later, received a renal transplant from his mother. This case illustrates that BK virus in severely immunocompromised HSCT recipient may lead to BK encephalitis and BKVN of native kidneys, even without hemorrhagic cystitis, leading to ESRD. Knowledge of such is important for appropriate timely evaluation and management.

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“…The PCR test is an elective test with 98% sensibility and 94% specificity but can be negative initially (4). The cerebral CT in the case of the herpetic virus can show no visible changes, sometimes a hypo intensity at temporal level (7). The cerebral MRI T1 sequence shows an edema and sometimes, a hyper signal in the regions with hemorrhage and delayed enhancement under different shapes: gyrus, leptomeningeal, diffuse and annular.…”

Section: Discussionmentioning

confidence: 99%

Therapeutic difficulties in vegetative epileptic seizures as a sign of acute viral encephalitis: case presentation

Iluţ

Nistor

Nemes

et al. 2020

BALNEO

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Acute encephalitis is a severe pathology represented by the inflammation of the brain parenchyma associated with neurological dysfunction. The etiology is predominantly viral or autoimmune, with different therapeutic approach. The typical manifestations include fever, epileptic seizures and neurological focal signs. The treatment consists in specific drug therapies regarding the etiology and rehabilitation therapies in case of incomplete recovery. We present a case of a 43-year-old woman with occipital cephalalgia and dizziness, associated with vesperal high blood pressure levels at the same hour daily. The brain MRI described possible acute encephalitis, with FLAIR and T2 hypersignal area on right parietal region and diffusion restriction. The lumbar puncture revealed no modifications and the EEG recordings showed irritative patterns. The acyclovir intravenous treatment and an antiepileptic drug were initiated. The repeated MRI revealed laminar necrosis which explained the vegetative epileptic seizures manifested with high blood pressure. The clinical status of the patient majorly improved due to specific treatment including rehabilitation interventions. Key words: acute viral encephalitis, vegetative epileptic seizures, laminar necrosis, cephalalgia, rehabilitation,

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Magnetic Resonance Imaging Findings in Viral Encephalitis: A Pictorial Essay

Cited by 46 publications

References 10 publications

Sudden visual loss: A not so simplex case

Sudden visual loss: A not so simplex case

BK virus encephalitis and end‐stage renal disease in a child with hematopoietic stem cell transplantation

Therapeutic difficulties in vegetative epileptic seizures as a sign of acute viral encephalitis: case presentation

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