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An Unusual Case of Japanese Encephalitis Involving Unilateral Deep Gray Matter and Temporal Lobe on Diffusion-Weighted MRI

  • Received : 2016.09.12
  • Accepted : 2016.10.17
  • Published : 2016.12.31

Abstract

Acute Japanese encephalitis (JE) is an endemic viral infectious disease in various parts of Far East and Southeast Asian countries including Korea. Bilateral thalami are the most common involving sites in JE. Other areas including the basal ganglia, substantia nigra, red nucleus, pons, cerebral cortex and cerebellum may be also involved. We report an extremely unusual brain diffusion-weighted MR imaging (DWI) findings in a 53-year-old man with serologically proven JE involving unilateral deep gray matter and temporal lobe, which shows multifocal high signal intensities in left thalamus, left substantia nigra, left caudate nucleus and left medial temporal cortex on T2-weighted image and DWI with iso-intensity on apparent diffusion coefficient (ADC) map.

Keywords

References

  1. Basumatary LJ, Raja D, Bhuyan D, Das M, Goswami M, Kayal AK. Clinical and radiological spectrum of Japanese encephalitis. J Neurol Sci 2013;325:15-21 https://doi.org/10.1016/j.jns.2012.11.007
  2. Kalita J, Misra UK. Comparison of CT scan and MRI findings in the diagnosis of Japanese encephalitis. J Neurol Sci 2000;174:3-8 https://doi.org/10.1016/S0022-510X(99)00318-4
  3. Kumar S, Misra UK, Kalita J, Salwani V, Gupta RK, Gujral R. MRI in Japanese encephalitis. Neuroradiology 1997;39:180-184 https://doi.org/10.1007/s002340050388
  4. Yakushiji Y, Kurohara K, Tanaka A, Kuroda Y, Uchino A. A case of Japanese encephalitis presenting with unilateral lesions in diffusion-weighted MRI. Rinsho Shinkeigaku 2001;41:602-605
  5. Solomon T. Viral encephalitis in Southeast Asia. Neurol Infect Epidemiol 1997;2:191-199
  6. Handique SK, Das RR, Barman K, et al. Temporal lobe involvement in Japanese encephalitis: problems in differential diagnosis. AJNR Am J Neuroradiol 2006;27:1027-1031
  7. Sawlani V. Diffusion-weighted imaging and apparent diffusion coefficient evaluation of herpes simplex encephalitis and Japanese encephalitis. J Neurol Sci 2009;287:221-226 https://doi.org/10.1016/j.jns.2009.07.010
  8. Hegde AN, Mohan S, Lath N, Lim CC. Differential diagnosis for bilateral abnormalities of the basal ganglia and thalamus. Radiographics 2011;31:5-30 https://doi.org/10.1148/rg.311105041
  9. Meissner B, Kallenberg K, Sanchez-Juan P, et al. Isolated cortical signal increase on MR imaging as a frequent lesion pattern in sporadic Creutzfeldt-Jakob disease. AJNR Am J Neuroradiol 2008;29:1519-1524 https://doi.org/10.3174/ajnr.A1122
  10. Zeidler M, Sellar RJ, Collie DA, et al. The pulvinar sign on magnetic resonance imaging in variant Creutzfeldt-Jakob disease. Lancet 2000;355:1412-1418 https://doi.org/10.1016/S0140-6736(00)02140-1