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Hemiplegia: an initial manifestation of Japanese encephalitis

A Nalini1, G R Arunodaya, A B Taly

  • 1Department of Neurology, National Institute of Mental Health and Neuro Sciences, Bangalore - 560029, India. nalini@nimhans.kar.nic.in

Neurology India
|December 4, 2003
PubMed

Insights

Japanese encephalitis (JE) is a rare cause of acute febrile illness with hemiplegia. This case highlights unusual prodromal hemiplegia in a child diagnosed with JE.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Pediatrics

Background:

  • Japanese encephalitis (JE) is a mosquito-borne viral illness prevalent in endemic areas.
  • JE typically presents with fever and neurological symptoms, but prodromal hemiplegia is uncommon.

Observation:

  • A 7-year-old boy in a JE-endemic region presented with acute febrile illness and left hemiplegia, maintaining consciousness.
  • Encephalitis symptoms developed 48 hours after hemiplegia onset.

Findings:

  • High IgM MAC ELISA titers for JE virus in serum and cerebrospinal fluid confirmed the diagnosis.
  • Brain MRI revealed asymmetrical bilateral thalamic hyperintense lesions on T2-weighted imaging, characteristic of JE.

Implications:

  • This case underscores the unusual presentation of JE with early-onset hemiplegia.
  • Recognizing atypical neurological manifestations is crucial for timely diagnosis and management of Japanese encephalitis in endemic regions.

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