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Persistent movement disorders following Japanese encephalitis
U A Murgod1, U B Muthane, V Ravi
1Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, India.
Abstract:
The authors report on movement disorders that persist for a long duration following Japanese encephalitis (JE). Fifteen patients with diagnosed JE were followed up after an interval of 3 to 5 years. Of the four patients with a movement disorder, two were children with severe generalized dystonia in whom MRI revealed bilateral thalamic lesions. The two adult patients had parkinsonism. MRI in both adult patients showed lesions confined to the substantia nigra. Viral antibody and antigen were absent in the CSF of all patients.
Insights
Japanese encephalitis (JE) can cause persistent movement disorders long after infection. MRI scans revealed specific brain lesions in children with dystonia and adults with parkinsonism following JE.
Area of Science:
- Neurology
- Infectious Diseases
- Neuroimaging
Background:
- Japanese encephalitis (JE) is a mosquito-borne viral illness with potential long-term neurological sequelae.
- Movement disorders are recognized but less commonly studied complications of JE survivors.
- Understanding the neuroanatomical correlates of these persistent disorders is crucial for patient management.
Purpose of the Study:
- To investigate the long-term presence and characteristics of movement disorders after Japanese encephalitis.
- To correlate specific movement disorders with neuroimaging findings in affected patients.
Main Methods:
- A follow-up study of fifteen patients diagnosed with Japanese encephalitis.
- Clinical assessment for movement disorders at 3 to 5 years post-infection.
- Magnetic Resonance Imaging (MRI) of the brain to identify lesions.
- Cerebrospinal fluid (CSF) analysis for viral markers.
Main Results:
- Four out of fifteen patients developed persistent movement disorders.
- Two pediatric patients presented with severe generalized dystonia, with MRI showing bilateral thalamic lesions.
- Two adult patients developed parkinsonism, with MRI revealing lesions localized to the substantia nigra.
- CSF analysis was negative for viral antibodies and antigens in all patients.
Conclusions:
- Movement disorders, including dystonia and parkinsonism, can be a long-term consequence of Japanese encephalitis.
- Specific brain regions, such as the thalamus and substantia nigra, are implicated in JE-related movement disorders.
- Neuroimaging plays a vital role in identifying the pathological basis of these persistent neurological deficits.