Serial magnetic resonance imaging in children with postinfectious encephalitis.
We analyzed follow-up magnetic resonance images (MRI) in eight children with clinical postinfectious encephalitis (PIE), and discussed their pathogeneses. Three categories of MRI findings were apparent: (1) multifocal lesions in the white matter with/without basal ganglia involvement consistent with acute disseminated encephalomyelitis (ADEM) (three patients); (2) single or multifocal lesions localized only in the gray matter (two patients); and (3) localized lesions in the brain stem, basal ganglia or cerebellum. Some lesions in the patients in Categories 1 and 2 migrated or were resolved quickly, sometimes within 10 days. Gadolinium caused linear or spotty enhancement in the patients in Category 2. These findings suggest that Categories 1 and 2 are a self-limiting allergic angiopathy without demyelination. In contrast, the lesions in the patients in Category 3 were fixed, and not resolved within 6 months (three patients). The pathogenesis of Category 3 is not known. All except one patient had no prednisolone (PSL) therapy, however; all lesions were resolved completely or markedly reduced in size, which indicates PSL therapy is not always necessary in patients with PIE.
Kimura
S
S
Yokohama City University, Urafune Hospital, Department of Pediatrics, Kanagawa, Japan.
Nezu
A
A
Ohtsuki
N
N
Kobayashi
T
T
Osaka
H
H
Uehara
S
S
D000293:Adolescent; D001921:Brain / Q000000981:diagnostic imaging / Q000821:virology; D002648:Child; D002675:Child, Preschool; D003711:Demyelinating Diseases / Q000145:classification / Q000175:diagnosis / Q000821:virology; D018792:Encephalitis, Viral / Q000145:classification / Q000175:diagnosis* / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D005682:Gadolinium; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D014057:Tomography, X-Ray Computed
D005682:Gadolinium