title: Cranial Ultrasonography in Infantile Encephalitic Beriberi: A Useful First-Line Imaging Tool for Screening and Diagnosis in Suspected Cases.
abstract: Brain imaging is central to the diagnosis of infantile encephalitic beriberi. Because cranial sonography findings have not been described in infantile encephalitic beriberi, our aim was to investigate its role in the diagnosis of this condition.
  
  
  
  We performed a retrospective review of head sonography of infants (admitted between November 1, 2014, and March 31, 2015) who presented with encephalopathy. Cranial ultrasonography scans were studied for the alteration of echogenicity of the basal ganglia.
  
  
  
  Of the 145 consecutive infants who presented with encephalopathy, 58 had thiamine-responsive encephalopathy (infantile encephalitic beriberi) and 87 had encephalopathy due to other causes. Forty-eight of 145 infants with encephalopathy showed hyperechoic basal ganglia. A hyperechoic appearance of the basal ganglia on cranial ultrasonography was found to have a sensitivity of 71% (41/58) and a specificity of 92% (80/87) in diagnosing infantile encephalitic beriberi. The sensitivity of cranial sonography increased with age. It was a maximum of 93% (14/15) in the 5 months and older age group. Specificity was a maximum of 100% (18/18) in infants older than 5 months of age. Sensitivity was maximum in Wernicke encephalopathy at 90% (18/20) and least in the acidotic form at 43% (10/23). Follow-up showed gradual normalization of the hyperechoic appearance of the basal ganglia during 8 weeks in 26/41 (63%), with mild atrophy of the basal ganglia in 6/41 (15%)
  
  
  
  Hyperechogenicity of the basal ganglia on cranial ultrasonography is a sensitive finding for the diagnosis of infantile encephalitic beriberi in infants who present with Wernicke encephalopathy.
authors.affiliation: From the Departments of Pediatric Radiology (N.A.W.) ahmad77chinar@gmail.com.
authors.forename: N A
authors.identifier: 0000-0003-1392-3552
authors.initials: NA
authors.lastname: Wani
authors.affiliation: Pediatrics (U.A.Q., K.A.), Government Medical College, Srinagar, Jammu and Kashmir, India.
authors.forename: U A
authors.identifier: 0000-0001-5738-4170
authors.initials: UA
authors.lastname: Qureshi
authors.affiliation: Pediatrics (U.A.Q., K.A.), Government Medical College, Srinagar, Jammu and Kashmir, India.
authors.forename: K
authors.identifier: 0000-0003-0333-2652
authors.initials: K
authors.lastname: Ahmad
authors.affiliation: Department of Radiology (N.A.C.), SheriKasmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India.
authors.forename: N A
authors.identifier: 0000-0002-2240-1898
authors.initials: NA
authors.lastname: Choh
mesh_terms: D001479:Basal Ganglia / Q000000981:diagnostic imaging* / Q000473:pathology; D001602:Beriberi / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D059906:Neuroimaging / Q000379:methods*; D012189:Retrospective Studies; D017585:Ultrasonography, Doppler, Transcranial / Q000379:methods*; D014899:Wernicke Encephalopathy / Q000000981:diagnostic imaging* / Q000209:etiology / Q000473:pathology