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Acute transient pseudoatrophy of the brain accompanying measles infection
1Division of Pediatric Neurology, Yokohama Ryouikuen,557-2, Ichizawa-cho, Asahi-ku, Yokohama 241-0014, Kanagawa, Japan. kaori-a@air.linkclub.or.jp
Insights
Transient brain pseudoatrophy in infants with measles infection may indicate acute encephalopathy. Early neuroimaging is recommended for children with mild drowsiness during measles.
Area of Science:
- Pediatrics
- Neurology
- Infectious Diseases
Background:
- Acute encephalopathy in infants can present with neurological symptoms.
- Measles infection is a known cause of various neurological complications in children.
- Transient brain pseudoatrophy has been documented in conditions like undernutrition and steroid overdose.
Observation:
- Two 1-year-old infants with acute encephalopathy following measles infection exhibited transient pseudoatrophy of the brain.
- The infants experienced 'mild drowsiness' post-measles, with no history of drug administration.
- One infant showed elevated neopterin levels in cerebrospinal fluid, suggesting glial cell activation.
Findings:
- The observed brain pseudoatrophy was transient and mild.
- The exact cause of pseudoatrophy in these cases remained undetermined.
- Glial cell activation associated with measles infection is a potential contributing factor.
Implications:
- Mild drowsiness during measles infection in infants may signify underlying acute encephalopathy.
- Recommend computed tomography (CT) or magnetic resonance imaging (MRI) for infants with drowsiness during measles.
- Highlights the importance of neuroimaging in diagnosing subtle neurological changes in pediatric measles cases.
Abstract:
Two infants, age 1 year, with acute encephalopathy who showed transient pseudoatrophy of the brain were reported. They each had measles infection, followed by 'mild drowsiness'. Reversible brain atrophy has been observed in patients with undernutrition, dehydration, and overdoses of steroids and valproic acid. However, these manifestations were very mild and there was no history of drug administration in our patients. The cause of the transient brain pseudoatrophy was unknown. However, activation of glial cells accompanying the measles infection was thought to be one possibility to see high value of neopterin (51 pmol/l) in the cerebrospinal fluid in one case. Although 'mild drowsiness' is not a rare manifestation in patients with measles infection, it is probable that their 'mild drowsiness' is caused by acute encephalopathy like in our cases. Thus, we recommend that computed tomography scanning or magnetic resonance imaging is performed in patients showing 'mild drowsiness' during measles infection.