title: Mumps encephalitis with akinesia and mutism.
abstract: Measles-rubella-mumps vaccination is routine in many countries, but the mumps vaccine remains voluntary and is not covered by insurance in Japan. A 5-year-old Japanese boy who had not received the mumps vaccine was affected by mumps parotitis. Several days later, he presented with various neurological abnormalities, including akinesia, mutism, dysphagia, and uncontrolled respiratory disorder. Mumps encephalitis was diagnosed. Despite steroid pulse and immunoglobulin treatment, the disease progressed. Magnetic resonance imaging showed necrotic changes in bilateral basal ganglia, midbrain, and hypothalamus. At 1 year follow up, he was bedridden and required enteral feeding through a gastric fistula and tracheostomy. Mumps vaccination should be made routine as soon as possible in Japan, because mumps encephalitis carries the risk of severe sequelae.
authors: Department of Pediatrics, Tokushima Prefectural Central Hospital, Tokushima, Japan.
authors: Kenichi
authors: K
authors: Suga
authors: Department of Pediatrics, Tokushima Prefectural Central Hospital, Tokushima, Japan.
authors: Aya
authors: A
authors: Goji
authors: Department of Pediatrics, Tokushima Prefectural Central Hospital, Tokushima, Japan.
authors: Miki
authors: M
authors: Shono
authors: Department of Pediatrics, Tokushima Prefectural Central Hospital, Tokushima, Japan.
authors: Sato
authors: S
authors: Matsuura
authors: Department of Pediatrics, Tokushima Prefectural Central Hospital, Tokushima, Japan.
authors: Miki
authors: M
authors: Inoue
authors: Department of Pediatrics, National Hospital Organization Tokushima Hospital, Tokushima, Japan.
authors: Eiko
authors: E
authors: Toda
authors: Department of Pediatrics, National Hospital Organization Tokushima Hospital, Tokushima, Japan.
authors: Tatsushi
authors: T
authors: Miyazaki
authors: Department of Pediatrics, Tokushima Prefectural Central Hospital, Tokushima, Japan.
authors: Masami
authors: M
authors: Kawahito
authors: Department of Pediatrics, Tokushima Prefectural Central Hospital, Tokushima, Japan.
authors: Kazuhiro
authors: K
authors: Mori
mesh_terms: D000405:Akinetic Mutism / Q000175:diagnosis / Q000209:etiology*; D002675:Child, Preschool; D004338:Drug Combinations; D018792:Encephalitis, Viral / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007564:Japan; D008279:Magnetic Resonance Imaging; D008297:Male; D022542:Measles-Mumps-Rubella Vaccine / Q000008:administration & dosage; D008775:Methylprednisolone / Q000627:therapeutic use; D009107:Mumps / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy; D011239:Prednisolone / Q000627:therapeutic use
chemical_list: D004338:Drug Combinations; D005938:Glucocorticoids; D016756:Immunoglobulins, Intravenous; D022542:Measles-Mumps-Rubella Vaccine; D011239:Prednisolone; D008775:Methylprednisolone
keywords: akinesia; encephalitis; mumps; mutism; vaccine