Leptomeningeal Enhancement without Thalamic Involvement as an Initial Manifestation of Japanese Encephalitis: A Case

Insights

Japanese encephalitis (JE) is a mosquito-borne viral infection. This rare case highlights unusual MRI findings, including leptomeningeal enhancement without thalamic involvement, offering new insights into JE diagnosis.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Radiology

Background:

  • Japanese encephalitis (JE) is a prevalent mosquito-borne viral illness in Southeast Asia.
  • Diagnosis often relies on Magnetic Resonance Imaging (MRI) revealing characteristic bilateral symmetric thalamic lesions.

Observation:

  • This report details an uncommon JE case presenting with leptomeningeal enhancement.
  • Crucially, this case lacked the typical thalamic involvement seen in standard JE presentations.

Findings:

  • Leptomeningeal enhancement resolved following treatment.
  • Follow-up MRI revealed new, non-specific multifocal bilateral white matter lesions.

Implications:

  • This case expands the spectrum of MRI findings in Japanese encephalitis.
  • It underscores the importance of considering atypical presentations for accurate JE diagnosis and management.