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[Encephalitis of the basel ganglia associated with mumps]
Abstract:
Two weeks after epidemic parotitis a 10-year old boy developed an acute extrapyramidal syndrome together with pyramidal tract signs but without impairment of consciousness. The CSF showed mild pleocytosis. The CT of the brain exhibited a well defined circumscribed and symmetrical swelling and hypodensity of the basal ganglia and of the internal capsule. Only slight and transient dysrhythmia was to be found in the EEG. Therapy with Prednisolone, Biperidene and Tiapride resulted in regression of symptoms. But one year later rigor and pyramidal tract signs remained evident in spite of intensive physiotherapy and logopaedic measures. Residual symmetric atrophia of the basal ganglia became evident in the CT by dilatation of the anterior horns of the lateral ventricles caused by lacking of the vault of the caudate nuclei heads.
Insights
A boy developed acute extrapyramidal syndrome after mumps, showing basal ganglia swelling on CT scans. Despite treatment, residual neurological deficits persisted, indicating potential long-term complications of mumps encephalitis.
Area of Science:
- Neurology
- Pediatrics
- Infectious Diseases
Background:
- Epidemic parotitis (mumps) can rarely lead to serious neurological complications.
- Acute extrapyramidal syndromes in children are uncommon post-viral sequelae.
Observation:
- A 10-year-old boy presented with acute extrapyramidal and pyramidal signs two weeks post-mumps, without consciousness impairment.
- Cerebrospinal fluid (CSF) revealed mild pleocytosis.
- Brain CT demonstrated symmetrical swelling and hypodensity in the basal ganglia and internal capsule.
Findings:
- Treatment with Prednisolone, Biperidene, and Tiapride led to symptom regression.
- One year later, persistent rigor and pyramidal signs were noted despite rehabilitation.
- Follow-up CT revealed residual basal ganglia atrophy, evidenced by dilated lateral ventricles due to caudate nucleus head volume loss.
Implications:
- This case highlights the potential for severe, long-lasting neurological damage following mumps encephalitis.
- Early recognition and intervention may mitigate acute symptoms but cannot always prevent chronic sequelae.
- Further research into the mechanisms of post-mumps encephalopathy and effective long-term management strategies is warranted.