Deterioration on magnetic resonance imaging despite good clinical recovery after viral encephalitis.
We present a 2-year-old patient who showed progressive widespread white-matter abnormalities on magnetic resonance imaging 1 month after viral encephalitis, despite her good clinical recovery. These lesions on magnetic resonance imaging had not responded to therapies commonly used to treat secondary immune-mediated demyelinating lesions, as observed in acute disseminated encephalomyelitis. Acute viral encephalitis caused cortical blindness, but no other clinical signs developed during her clinical course. The progressive white-matter lesion in our case was different from the exacerbation of viral encephalitis or secondary immune-mediated encephalitis. A year later, magnetic resonance imaging-demonstrated brain atrophy with cystic changes in the bilateral occipital area, with remarkably reduced white-matter lesions. We hypothesize that the progressive white-matter changes resulted from the process of atrophy, degeneration, and cystic formation after viral encephalitis, rather than from the immune-mediated demyelinating process.
Awaya
Tomonari
T
Department of Pediatrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Kato
Takeo
T
Shibata
Minoru
M
Yamanaka
Yasunari
Y
Nakahata
Tatsutoshi
T
D002675:Child, Preschool; D018792:Encephalitis, Viral / Q000473:pathology* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D020127:Recovery of Function / Q000502:physiology*; D014057:Tomography, X-Ray Computed / Q000379:methods