Neuroimaging Findings in Rabies Encephalitis

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.