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Moyamoya disease mimicking encephalitis.
Maryam Khalesi1, Masoud Pezeshki Rad2, Abdolkarim Hamedi3
1Department of Pediatrics, Ghaem Medical Center, Mashhad University of Medical Sciences, Mashhad, Iran;
Iranian Journal of Medical Sciences
|September 23, 2014
Summary
Moyamoya disease, a rare condition causing artery stenosis, was diagnosed in a child presenting with encephalitis-like symptoms. Brain MRI revealed characteristic moyamoya vessels, highlighting the importance of considering vascular events in pediatric encephalitis.
Area of Science:
- Neurology
- Pediatrics
- Vascular Medicine
Background:
- Moyamoya disease is a rare, idiopathic vaso-occlusive condition.
- It involves internal carotid artery stenosis and collateral network formation.
Observation:
- A 15-month-old girl presented with decreased consciousness, seizures, and fever, initially suspected as encephalitis.
- Initial CT scans were inconclusive, and standard encephalitis treatments yielded no improvement.
- Neurological examination revealed left-sided hemiparesis.
Findings:
- Brain MRI demonstrated hyperintensities in the right frontal and parietal lobes, indicative of vascular lesions.
- Magnetic Resonance Angiography (MRA) confirmed bilateral basal ganglia vessel abnormalities consistent with moyamoya disease.
- Cerebrospinal fluid (CSF) analysis and cultures were negative for infection.
Implications:
- Encephalitis in children warrants consideration of underlying vascular events like moyamoya disease.
- Brain MRI and MRA are crucial diagnostic tools for identifying moyamoya disease in pediatric cases.
- Differential diagnosis for pediatric encephalitis should include rare vascular disorders.
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