Acute relapsing encephalopathy mimicking acute necrotizing encephalopathy in a 4-year-old boy

• Published in: Brain & development (Tokyo. 1979) Vol. 21; no. 8; pp. 554 - 558
• Main Authors: Suwa, Kiyotaka, Yamagata, Takanori, Momoi, Mariko Y., Kawakami, Akio, Kikuchi, Yutaka, Miyao, Masutomo, Hirokawa, Hideaki, Oikawa, Tadao
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier B.V 01.12.1999; Elsevier Science
• Subjects: Acute encephalopathy; Acute necrotizing encephalopathy; Biological and medical sciences; Brain - pathology; Child, Preschool; Disease Progression; Human viral diseases; Humans; Infectious diseases; Japan; Leigh Disease - pathology; Leigh Disease - physiopathology; Magnetic Resonance Imaging; Male; Medical sciences; Recurrence; Viral diseases; Viral diseases of the nervous system; Virus-induced encephalitis; Japan; Virus-induced encephalitis; Magnetic resonance imaging; Acute necrotizing encephalopathy; Acute encephalopathy; Human; Nervous system diseases; Acute; Male; Recurrent; Nuclear magnetic resonance imaging; Differential diagnostic; Cerebral disorder; Necrosis; Infection; Case study; Encephalopathy; Viral disease; Central nervous system disease; Medical imagery; Evolution; Child
• ISSN: 0387-7604; 1872-7131
• DOI: 10.1016/S0387-7604(99)00078-9

A 4-year-old boy showed two episodes of encephalitis/encephalopathy involving disturbed consciousness, convulsion, and paresis associated with the elevated levels of protein and myelin basic protein of the cerebrospinal fluid. MRI studies of the brain revealed symmetrical lesions in the brain stem and thalami at the first episode, and additional lesions were found in the cerebellum involving both the gray and white matter in the second episode. The intensities of MRI lesions were low in T1 and high in T2. These episodes were followed by an elevation of the anti-viral antibody titers, for influenza A virus during the first episode and for adenovirus during the second. In the second episode, intravenous methylprednisolone therapy resulted in rapid improvement of his neurological signs.