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A possible case of acute disseminated encephalomyelitis after Japanese encephalitis

Wei-Liang Chen1, Ming-Feng Liao2, Han-Lin Chiang3

  • 1Medical College of Wisconsin, Children's Hospital of Wisconsin.

Acta Neurologica Taiwanica
|January 25, 2014
PubMed
Abstract

Insights

This case report details a patient who developed Acute Disseminated Encephalomyelitis (ADEM) after recovering from Japanese encephalitis. High-dose steroid therapy led to significant improvement in neurological symptoms and MRI findings.

Area of Science:

  • Neurology
  • Immunology
  • Infectious Diseases

Background:

  • Acute Disseminated Encephalomyelitis (ADEM) is a monophasic central nervous system (CNS) demyelination disease often preceded by infection.
  • Japanese encephalitis (JE) is a mosquito-borne viral illness with known neurological complications.
  • Post-infectious autoimmune events following JE are rare, with limited reports of Guillain-Barre syndrome and vaccine-related ADEM.

Observation:

  • A 50-year-old male presented with symptoms of JE, including headache, fever, and altered consciousness.
  • After initial recovery and discharge, the patient experienced a relapse with consciousness impairment and behavioral changes.
  • Brain MRI confirmed newly developed diffuse white matter lesions, indicative of ADEM.

Findings:

  • The patient was diagnosed with a possible case of ADEM occurring subsequent to Japanese encephalitis.
  • Treatment with high-dose intravenous methylprednisolone and oral steroids resulted in gradual improvement of clinical symptoms.
  • MRI abnormalities indicative of ADEM showed progressive improvement following immunosuppressive therapy.

Implications:

  • This case suggests a potential link between Japanese encephalitis and the development of ADEM.
  • Early recognition and prompt treatment with high-dose corticosteroids may lead to favorable outcomes in ADEM post-JE.
  • Further research is warranted to elucidate the immunopathogenesis of ADEM following viral encephalitis.

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