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[Clinical variability in viral infection related acute encephalitis or encephalopathy]

Seiji Kimura1

  • 1Hata Kibou No Ie.

Nihon Rinsho. Japanese Journal of Clinical Medicine
|March 16, 2011
PubMed

Insights

Acute encephalopathy (AEP) and acute encephalitis (AE) in children present diverse symptoms and neuroimaging results. Understanding lesion location and MRI findings aids in diagnosing these serious pediatric neurological conditions.

Area of Science:

  • Pediatric Neurology
  • Neuroimaging
  • Infectious Diseases

Context:

  • Acute encephalopathy (AEP) and acute encephalitis (AE) are critical pediatric neurological conditions.
  • Clinical and neuroimaging findings in AEP and AE are highly variable.
  • Lesion location significantly influences the presentation of acute encephalitis.

Purpose:

  • To summarize the variable clinical manifestations and neuroimaging findings in pediatric AEP and AE.
  • To categorize MRI findings in AEP.
  • To highlight the association between elevated serum AST, DIC, and specific AEP subtypes.

Summary:

  • Patients with AE exhibit diverse symptoms like altered consciousness, seizures, and ataxia, depending on lesion location (basal ganglia, brain stem, cerebellum, cerebral matter).
  • AEP MRI findings include severe brain edema, acute necrotizing encephalopathy, and cortical necrosis.
  • Elevated serum AST occurs in ~50% of AEP patients, with ~60% developing DIC, often seen in Reye syndrome and AEP with shock.

Impact:

  • Improved diagnostic accuracy for AEP and AE through understanding varied presentations.
  • Enhanced differentiation of AEP subtypes based on neuroimaging characteristics.
  • Clinical insights into the correlation between AST levels, DIC, and specific AEP syndromes.

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