Rotavirus encephalopathy with concomitant acute cerebellitis: report of a case and review of the literature

Paketçi, Cem; Edem, Pınar; Okur, Derya; Sarıoğlu, Fatma Ceren; Güleryüz, Handan; Bayram, Erhan; Kurul, Semra Hız; Yış, Uluç

doi:10.24953/turkjped.2020.01.017

Cited by 7 publications

(5 citation statements)

References 9 publications

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“…In contrast to the current literature, most of our patients (8/10, 80.0%) did not receive dexamethasone or methylprednisolone. 7,18 Despite the retrospective design of our study and thus lack of standardized follow-up, these observations suggest that no specific intervention other than supportive care is needed to treat neurologic complications of rotaviral infections. Future prospective (intervention) studies are required to further address this issue.…”

Section: Discussionmentioning

confidence: 87%

“…2 Besides the intestinal symptoms that are associated with ordinary gastroenteritis, several studies, based on individual cases or small case series, also described the occurrence of neurologic manifestations such as encephalitis, encephalopathy, cerebellitis, meningitis, status epilepticus and afebrile convulsions. [3][4][5][6][7] In some of these cases, the clinical manifestations were accompanied by abnormalities in brain magnetic resonance imaging (MRI), which were usually reversible. 6,8,9 The pathogenic mechanism by which rotavirus causes neurologic symptoms has not been fully elucidated and may well be multifactorial.…”

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confidence: 99%

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Neurologic Complications of Rotavirus Infections in Children

Slotboom

Peeters

Groeneweg

et al. 2023

Pediatric Infectious Disease Journal

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Background: Rotavirus is the leading cause of complicated gastroenteritis in children younger than 5 years in countries where rotavirus vaccination is not implemented as a routine vaccination. Besides the intestinal symptoms that are associated with ordinary gastroenteritis, rotavirus can cause neurological complications. The aim of this study is to describe the clinical characteristics of complicated rotavirus infections. Methods: From January 1, 2016 to January 31, 2022, all children (below the age of 18 years) with a positive rotavirus test in feces that were either hospitalized or presented at the outpatient clinic or emergency department of a large pediatric hospital in the Netherlands were included. Rotavirus was only tested in case of a severe or abnormal disease course. We described the clinical characteristics and outcomes with a particular focus on neurological manifestations. Results: In total, 59 patients with rotavirus were included of whom 50 (84.7%) were hospitalized and 18 (30.5%) needed intravenous rehydration. Ten patients (16.9%) had neurologic complications, of whom 6 patients (60.0%) presented encephalopathy. Two patients (20.0%) with neurological symptoms showed abnormalities on diagnostic imaging. Conclusions: Rotavirus can cause gastroenteritis with severe, but apparently self-limiting, neurological manifestations. Considering rotavirus in pediatric patients with neurological symptoms such as encephalopathy and encephalitis is therefore important. Early detection of rotavirus infection may predict a favorable course of the disease and may thereby prevent unnecessary treatment and should be further investigated.

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Section: Discussionmentioning

confidence: 87%

mentioning

confidence: 99%

Neurologic Complications of Rotavirus Infections in Children

Slotboom

Peeters

Groeneweg

et al. 2023

Pediatric Infectious Disease Journal

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“…The analysis of the literature revealed 794 publications, 83 of which were included in this systematic review (Figure 1). Out of these, 68 permitted a detailed analysis of cases 4–8,11,17–78 while 15 publications, dealing with CwG and rotavirus infection, only reported prevalence and therefore did not allow a detailed analysis 10,48,79–91 . Although these latter 15 publications were not included in the systematic analysis, they were used to calculate the prevalence of CwG in rotavirus infection or the prevalence of rotavirus infection in patients with CwG (Figure 1).…”

Section: Resultsmentioning

confidence: 99%

Neurological complications of rotavirus infection in children: A systematic review and meta‐analysis

et al. 2023

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Rotavirus is a common cause of benign, self-limiting gastroenteritis in childhood. 1,2 Apart from dehydration and electrolyte imbalance, several neurological complications have been described in rotavirus infections in recent years, such as encephalitis, cerebellitis and a condition described as benign convulsions with mild gastroenteritis (CwG). [3][4][5][6] A direct viral pathomechanism has been postulated since the virus was first detected in the cerebrospinal fluid of a patient suffering from encephalitis in 1995 4 and in subsequent reports. 6,7 CwG was first described in 1982 by Morooka et al. in patients who presented with convulsions associated with mild gastroenteritis without fever or laboratory abnormalities. 3 The definition of CwG was further elaborated in 1992 by Komori et al. as convulsions in

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“…The most frequently reported causes were cerebellitis due to rotavirus ( n = 17 in 5 case reports [ 16 , 27 , 34 , 39 , 41 ] followed by cerebellitis or encephalopathy from influenza virus A/B ( n = 3 [ 19 , 38 , 42 ]), cerebellitis from varicella-zoster virus ( n = 2 [ 10 , 17 ]) and pneumococcal meningitis ( n = 1 [ 15 ]). In 10 cases (8 case reports [ 9 , 14 , 29 – 31 , 35 – 37 ]), cerebellitis and acute disseminated encephalomyelitis were described without an identified pathogen.…”

Section: Resultsmentioning

confidence: 99%

Cerebellar mutism syndrome of non-tumour surgical aetiology—a case report and literature review

et al. 2023

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Cerebellar mutism syndrome (CMS) is a well-known complication of posterior fossa (PF) tumour surgery. CMS has previously been reported in cases of non-tumour surgical aetiology in a limited number of publications. We report a case of a 10-year-old girl who suffered a cerebellar haemorrhage and subsequent CMS following surgical treatment of a ruptured arteriovenous malformation (AVM) in the cerebellar vermis. The AVM was removed acutely through a transvermian access, and hydrocephalus was treated with temporary external drainage. In the postoperative period, she suffered diffuse vasospasms of the anterior cerebral circulation and had a permanent shunt placed for hydrocephalus. Her mutism resolved after 45 days but severe ataxia persisted. To our knowledge, this is the first reported case of CMS related to a vermian haemorrhagic stroke with postoperative diffuse vasospasms. Based on this case, we present a literature review on CMS of non-tumour surgical origin in children.

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Rotavirus encephalopathy with concomitant acute cerebellitis: report of a case and review of the literature

Cited by 7 publications

References 9 publications

Neurologic Complications of Rotavirus Infections in Children

Neurologic Complications of Rotavirus Infections in Children

Neurological complications of rotavirus infection in children: A systematic review and meta‐analysis

Cerebellar mutism syndrome of non-tumour surgical aetiology—a case report and literature review

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