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Magnetic resonance imaging in a case of mumps postinfectious encephalitis with asymptomatic optic neuritis
K Sugita1, M Ando, K Minamitani
1Department of Paediatrics, Chiba University School of Medicine, Japan.
Abstract:
A 5-year-old male patient with asymptomatic optic neuritis and mumps postinfectious encephalitis or acute disseminated encephalomyelitis is reported. Magnetic resonance imaging (MRI) with a short inversion time inversion recovery sequence was valuable in detecting clinically silent lesions of the unilateral right optic nerve in addition to visual evoked potentials. Evidence of concurrent optic neuritis was useful for detecting more extensive neurological involvement, leading to the diagnosis of mumps postinfectious encephalitis. A systematic MRI study should be performed in children with mumps encephalitis, regardless of appreciable clinical deficits.
Insights
Mumps encephalitis in children can cause silent optic nerve damage, detected by MRI. Early MRI is crucial for diagnosing extensive neurological involvement, even without clear symptoms.
Area of Science:
- Neurology
- Pediatrics
- Radiology
Background:
- Mumps postinfectious encephalitis and acute disseminated encephalomyelitis are rare but serious neurological complications in children.
- Optic neuritis, inflammation of the optic nerve, can be a presenting sign of these conditions.
Observation:
- A 5-year-old boy presented with asymptomatic optic neuritis and symptoms suggestive of mumps postinfectious encephalitis.
- Magnetic resonance imaging (MRI) using a short inversion time inversion recovery sequence identified clinically silent lesions in the optic nerve.
- Visual evoked potentials also aided in detecting optic nerve involvement.
Findings:
- Concurrent optic neuritis was a key indicator of more widespread neurological involvement.
- The findings led to the diagnosis of mumps postinfectious encephalitis.
- MRI proved valuable in detecting subclinical neurological deficits.
Implications:
- A systematic MRI evaluation is recommended for all children diagnosed with mumps encephalitis, irrespective of apparent clinical deficits.
- Early detection of neurological involvement through MRI can lead to timely diagnosis and management.
- This case highlights the importance of advanced neuroimaging in pediatric neurology for identifying silent lesions.