Japanese Encephalitis Associated With Quadriplegia: The First Reported Case of Nepal

Area of Science:

• Neurology
• Infectious Diseases
• Public Health

Background:

• Japanese encephalitis (JE) is a mosquito-borne viral illness prevalent in Asia, often causing severe neurological complications, particularly in children and adolescents.
• JE-associated paralysis, though rare, represents a significant neurological manifestation requiring prompt medical attention.

Purpose of the Study:

• To report the first documented case of Japanese encephalitis-associated quadriplegia in Nepal.
• To emphasize the importance of early diagnosis, intervention, and rehabilitation for severe JE cases.

Main Methods:

• A case study of a 19-year-old male presenting with fever, altered sensorium, vomiting, and quadriplegia.
• Diagnostic procedures included neurological examination, cerebrospinal fluid analysis, brain imaging, and serological testing for JEV-specific IgM antibodies.
• Treatment involved supportive care, including hydration, antipyretics, antibiotics, and corticosteroids.

Main Results:

• The patient presented with acute neurological symptoms, including quadriplegia, following a febrile illness.
• Diagnosis was confirmed via positive serum JEV-specific IgM antibodies.
• Significant improvement in motor function was observed within two weeks of hospitalization with supportive management.

Conclusions:

• This case highlights Japanese encephalitis as a cause of quadriplegia and the need for vigilance in endemic areas.
• Prompt diagnosis, supportive treatment, and rehabilitation are crucial for managing severe JE manifestations.
• Adherence to national JE vaccination programs is essential for preventing such debilitating neurological outcomes.