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Updated: Jun 27, 2026
High-Resolution 3D Imaging of Rabies Virus Infection in Solvent-Cleared Brain Tissue
Published on: April 30, 2019
Neuroimaging Findings in Rabies Encephalitis
Maya Dattatraya Bhat1, Priyanka Priyadarshini1, Chandrajit Prasad1
1Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.
Background And Purpose:
Rabies encephalitis is a near-fatal zoonotic disease that is usually diagnosed on clinical grounds in conjunction with characteristic history. Owing to its rapidly progressive nature, imaging is seldom performed, and hence a description of imaging findings in rabies encephalitis is anecdotal and limited.
Methods:
We describe MRI findings in eight confirmed rabies cases that presented to our institute over the last 21 years.
Results:
Most of the patients' imaging patterns are in concordance with the described literature. However, we hereby demonstrate the involvement of novel structures like dentate nuclei, cranial nerves, and meninges besides the hot cross bun sign in the pons and the presence of diffusion restriction in many gray and white matter structures of the brain.
Conclusion:
Knowledge of the broad imaging spectrum of rabies may expedite the diagnosis, especially the paralytic form, which is prone to clinical misdiagnosis as Guillain-Barre syndrome or acute disseminated encephalomyelitis.
Insights
Rabies encephalitis, a fatal zoonotic disease, shows characteristic MRI findings. This study details novel imaging patterns, aiding in earlier diagnosis of this rapidly progressive neurological condition.
Area of Science:
- Neurology
- Radiology
- Infectious Diseases
Background:
- Rabies encephalitis is a severe zoonotic disease often diagnosed clinically.
- Its rapid progression limits diagnostic imaging, resulting in anecdotal findings.
- Accurate diagnosis is crucial, as paralytic rabies can mimic other neurological disorders.
Purpose of the Study:
- To describe the magnetic resonance imaging (MRI) findings in confirmed cases of rabies encephalitis.
- To expand the understanding of the imaging spectrum of rabies.
- To aid in the early diagnosis of rabies, particularly its paralytic form.
Main Methods:
- Retrospective analysis of MRI scans from eight confirmed rabies cases.
- Cases were collected over a 21-year period at a single institute.
- Correlation of imaging findings with clinical diagnosis.
Main Results:
- MRI findings in most cases aligned with existing literature.
- Novel findings included involvement of dentate nuclei, cranial nerves, and meninges.
- The 'hot cross bun' sign in the pons and diffusion restriction in gray/white matter were observed.
Conclusions:
- Familiarity with the diverse MRI findings in rabies encephalitis can expedite diagnosis.
- Early diagnosis is critical, especially for the paralytic form, to prevent misdiagnosis.
- Imaging plays a vital role in identifying rabies, complementing clinical assessment.
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