title: Clinical and radiological predictors of outcome for Murray Valley encephalitis.
abstract: A review of the laboratory-confirmed cases of Murray Valley encephalitis (MVE) from Western Australia between 2009 and 2011 was conducted to describe the clinical, laboratory, and radiological features of the disease. The nine encephalitis patients presented with altered mental state and seizures, tremor, weakness, or paralysis. All patients developed a raised C-reactive protein, whereas most developed acute liver injury, neutrophilia, and thrombocytosis. All patients with encephalitis developed cerebral peduncle involvement on early magnetic resonance imaging (MRI). The absence of thalamic MRI hyperintensity during the acute illness, with or without leptomeningeal enhancement, predicted a better neurological outcome, whereas those patients with widespread abnormalities involving the thalamus, midbrain, and cerebral cortex or the cerebellum had devastating neurological outcomes. MRI scans repeated months after acute illness showed destruction of the thalamus and basal ganglia, cortex, or cerebellum. These findings may help clinicians predict the neurological outcome when evaluating patients with MVE.
authors.affiliation: Department of Microbiology, PathWest Laboratory Medicine WA, Nedlands, Western Australia, Australia. david.speers@health.wa.gov.au
authors.forename: David J
authors.initials: DJ
authors.lastname: Speers
authors.forename: James
authors.initials: J
authors.lastname: Flexman
authors.forename: Christopher C
authors.initials: CC
authors.lastname: Blyth
authors.forename: Nirooshan
authors.initials: N
authors.lastname: Rooban
authors.forename: Edward
authors.initials: E
authors.lastname: Raby
authors.forename: Ganesh
authors.initials: G
authors.lastname: Ramaseshan
authors.forename: Susan
authors.initials: S
authors.lastname: Benson
authors.forename: David W
authors.initials: DW
authors.lastname: Smith
mesh_terms: D000328:Adult; D000368:Aged; D001921:Brain / Q000473:pathology*; D002675:Child, Preschool; D018068:Encephalitis Virus, Murray Valley; D004671:Encephalitis, Arbovirus / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome; D014904:Western Australia / Q000453:epidemiology