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Related Concept Videos

Arboviral Encephalitis01:25

Arboviral Encephalitis

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Arboviral encephalitis refers to brain inflammation caused by arthropod-borne viruses, particularly those transmitted through mosquito vectors. Among these, West Nile virus (WNV), a member of the Flaviviridae family, is a significant public health concern. WNV is an enveloped, positive-sense, single-stranded RNA virus. Human infection typically begins when an infected mosquito introduces the virus into the dermis during feeding. The primary transmission cycle involves birds as amplifying hosts...
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Viral meningitis is the most common form of meningitis and is often referred to as aseptic meningitis to indicate the absence of bacterial involvement. It is generally milder than bacterial meningitis, with symptoms including fever, headache, stiff neck, drowsiness, nausea, photophobia, and vomiting. Rarely, more severe manifestations or death may occur. Common causative agents include enteroviruses, particularly coxsackie A and B viruses and echoviruses, all members of the Enterovirus genus...
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Seizures: Classification01:13

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Epilepsy is primarily characterized by unpredictable seizures, either provoked by an identifiable factor, such as injury or illness, or unprovoked, occurring spontaneously without apparent cause.
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Focal Seizures
Focal seizures originate from specific regions of the brain. These seizures are further sub-classified into two types:
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Can we differentiate between herpes simplex encephalitis and Japanese encephalitis?

Jayantee Kalita1, Usha Kant Misra1, Vinita Elizabeth Mani1

  • 1Department of Neurology, Sanjay Gandhi Post Graduate Medical Sciences, Lucknow, India.

Journal of the Neurological Sciences
|June 12, 2016
PubMed
Summary

Herpes simplex encephalitis (HSE) and Japanese encephalitis (JE) present differently; HSE often causes seizures and behavioral issues, while JE leads to movement disorders. Temporal lobe MRI findings suggest HSE, whereas thalamic lesions indicate JE, with JE patients showing better long-term outcomes.

Keywords:
EEGEncephalitisHerpes simplex encephalitisJapanese encephalitisMRIOutcome

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Area of Science:

  • Neurology
  • Infectious Diseases
  • Neuroimaging

Background:

  • Herpes simplex encephalitis (HSE) requires differentiation from arboviral encephalitis, particularly Japanese encephalitis (JE), due to treatment implications.
  • HSE lacks specific regional or seasonal occurrence patterns, unlike JE which is often seasonal.

Purpose of the Study:

  • To evaluate clinical, MRI, and laboratory findings to differentiate HSE from JE.
  • To compare patient outcomes and neurological sequelae between HSE and JE.

Main Methods:

  • Retrospective analysis of 10-year confirmed JE and HSE patient data.
  • Clinical symptom assessment (seizures, behavioral changes, focal weakness, movement disorders).
  • Cranial MRI, EEG, CSF analysis, and blood tests were performed; outcomes assessed using modified Rankin Scale (mRS).

Main Results:

  • HSE patients exhibited higher rates of seizures (86%) and behavioral abnormalities (48%) compared to JE.
  • JE patients showed a higher incidence of movement disorders (76%) and focal reflex loss (42%).
  • Temporal lobe MRI lesions were specific to HSE, while thalamic involvement indicated JE; JE patients had better 1-year outcomes (48%) than HSE patients (24%).

Conclusions:

  • Clinical presentation and MRI findings, specifically temporal lobe (HSE) versus thalamic (JE) lesions, aid in differentiating these encephalitis types.
  • HSE is associated with a higher prevalence of seizures and behavioral abnormalities, whereas JE is linked to focal reflex loss and movement disorders.
  • Japanese encephalitis generally has a better long-term prognosis than herpes simplex encephalitis.