2014
DOI: 10.1212/wnl.0000000000000040
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Teaching Neuro Images : Neonatal parechovirus encephalitis

Abstract: A full-term 9-day-old girl presented with fever, irritability, and seizures. The routine CSF examination, cranial ultrasound, and laboratory tests were normal. Brain MRI showed diffuse white matter abnormality (figure). Human parechovirus (HPeV) type 3 was isolated in both CSF and blood. The neurodevelopmental outcome at 4 months is poor, and MRI shows an extensive cystic leukomalacia in the frontal white matter.The diagnosis of HPeV infection can be made from a positive HPeV PCR in CSF and blood. Extensive wh… Show more

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Cited by 22 publications
(17 citation statements)
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“…The pattern of WMI seen in rotavirus infections is not unique and is, in fact, strikingly similar to that seen in neonatal enterovirus and parechovirus encephalitis11293031323334). In all 3 infections, the major findings on cerebral imaging are diffuse high signal intensity in the white matter on T2-weighted sequences and restricted diffusion in the periventricular white matter, corpus callosum, and deep white matter.…”
Section: Comparisons With Other Viral Infectionsmentioning
confidence: 57%
See 2 more Smart Citations
“…The pattern of WMI seen in rotavirus infections is not unique and is, in fact, strikingly similar to that seen in neonatal enterovirus and parechovirus encephalitis11293031323334). In all 3 infections, the major findings on cerebral imaging are diffuse high signal intensity in the white matter on T2-weighted sequences and restricted diffusion in the periventricular white matter, corpus callosum, and deep white matter.…”
Section: Comparisons With Other Viral Infectionsmentioning
confidence: 57%
“…In all 3 infections, the major findings on cerebral imaging are diffuse high signal intensity in the white matter on T2-weighted sequences and restricted diffusion in the periventricular white matter, corpus callosum, and deep white matter. However, the signal changes seen on conventional MRI sequence are more subtle in the WMI of rotavirus infections than in the WMI related to enterovirus and parechovirus infections3034). A predilection for cystic evolution in the frontal lobes is another common feature1112183031), as is the timing of WMI susceptibility following viral infection.…”
Section: Comparisons With Other Viral Infectionsmentioning
confidence: 99%
See 1 more Smart Citation
“…11,14,16,20,23 Other studies of HPeV3 CNS infection include relatively few, if any, cliniciandiagnosed encephalitis cases. 6,8,11,14,16,20,22,26,27,41 Among these cases, young age and female gender were prominent (data not presented).The MRI findings of bilateral symmetrical WM abnormalities with diffusion restriction, where present, should encourage clinicians to consider testing for HPeV in cases of neonatal encephalitis/encephalopathy. Diffusion-weighted imaging (DWI) appears particularly sensitive and characteristic in HPeV encephalitis.…”
Section: ; Nil/minor Sequelae Signifi Cant Concernmentioning
confidence: 98%
“…9,10 Patient data. A total of 85 neonates (,28 days) were identified in an institutional review board-approved retrospective search of the electronic medical record for neonates diagnosed with seizures or apnea at Gyengsang National University Hospital (Jinju, Korea) from January 2009 to February 2014.…”
mentioning
confidence: 99%