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[Acute encephalitis: bilateral lesions of the basal ganglia]
1División de Neurología, Hospital de Niños R. Gutiérrez, Buenos Aires, Argentina. grippo@fibertel.com.ar
Insights
Acute encephalitis causing bilateral basal ganglia lesions resulted in varied neurological outcomes in two children. Age at disease onset appears to influence the severity of neurological sequelae.
Area of Science:
- Neurology
- Pediatrics
- Neuroimaging
Background:
- Acute encephalitis is a serious neurological condition that can affect children.
- Basal ganglia lesions on Magnetic Resonance Imaging (MRI) are a significant finding in encephalitis.
- Understanding the long-term neurological outcomes is crucial for patient management.
Observation:
- Two pediatric patients presented with acute encephalitis and bilateral basal ganglia lesions identified via MRI.
- Clinical presentation included abnormal movements such as tremor, choreoathetosis, and dystonia.
- Follow-up revealed distinct neurological sequelae, with the younger child experiencing more severe and persistent symptoms.
Findings:
- MRI confirmed bilateral basal ganglia lesions in both cases of acute encephalitis.
- Neurological outcomes differed significantly between the two children.
- The 9-year-old showed mild residual symptoms, while the 15-month-old exhibited persistent generalized dystonia and choreoathetosis.
Implications:
- Age at presentation is a critical factor in determining the neurological sequelae of acute encephalitis with basal ganglia involvement.
- These findings highlight the importance of early diagnosis and monitoring for movement disorders in affected children.
- Further research is warranted to elucidate the precise mechanisms linking age, basal ganglia lesions, and long-term neurological deficits in encephalitis.
Objective:
To refer two children with acute encephalitis and bilateral basal ganglia lesion and its neurological outcome.
Clinical Cases:
Two girls, one of 9 years and the other of 15 months of age were affected by acute encephalitis, bilateral basal ganglia lesion was found on MRI in both children. Abnormal movements (tremor, choreoatetosis) and dystonia were the main symptomatology. In the first girl a mild dystonic posture on her hand and minor bradykinesia was the only found after a 4 year follow up. The other child, after 17 months of the beginning of her disease, still has generalized dystonia and choreoatetosis movements. Control MRI studies, in both patients remain without changes.
Conclusion:
In acute encephalitis, basal ganglia lesion in two children, produced different neurological sequelae, probably related to the age of the presentation of the disease.