Document Detail


Acute encephalopathy with bilateral striatal necrosis: favourable response to corticosteroid therapy.
MedLine Citation:
PMID:  10728192     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A case of acute encephalopathy with selective bilateral symmetrical striatal lesions is reported. The patient was a previously healthy 4-year-old boy who became obtunded after a febrile illness and fell into a state of delirium with severe pain in the feet. He showed abnormal postures: hyperextension of the neck and upper limbs and extreme flexion of both lower limbs, and abnormal involuntary movements of the limbs: tremor, athetotic movement and right hemiballismus. Analysis of serum antibody titres suggested recent primary infection of herpes simplex type 1 (HSV-1). Cranial T2-weighted magnetic resonance imaging (MRI) demonstrated areas of high-signal intensity involving the whole basal ganglia bilaterally. He showed rapid clinical improvement after the initiation of corticosteroid therapy; complete clinical recovery was noted 3 months after the onset. Serial MRI studies demonstrated a rapid reduction of the lesions, resulting in only slight T2-hyperintense areas in both caudate nuclei. The pathogenesis of the disorder remains unknown, though an autoimmune mechanism has been speculated. The clinical and laboratory findings in this case suggested a possible role of HSV-1 in the pathomechanism of the disorder and a beneficial effect of early corticosteroid therapy.
Authors:
K Yamamoto; H O Chiba; M Ishitobi; H Nakagawa; T Ogawa; K Ishii
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  European journal of paediatric neurology : EJPN : official journal of the European Paediatric Neurology Society     Volume:  1     ISSN:  1090-3798     ISO Abbreviation:  Eur. J. Paediatr. Neurol.     Publication Date:  1997  
Date Detail:
Created Date:  2000-04-12     Completed Date:  2000-04-12     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9715169     Medline TA:  Eur J Paediatr Neurol     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  41-5     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, Sendai City Hospital, Japan.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Basal Ganglia Diseases / diagnosis,  drug therapy*
Child, Preschool
Corpus Striatum / drug effects*,  pathology
Dominance, Cerebral* / drug effects
Encephalitis, Viral / diagnosis,  drug therapy*
Glucocorticoids / administration & dosage*
Herpes Simplex / diagnosis,  drug therapy*
Humans
Magnetic Resonance Imaging
Male
Necrosis
Prednisolone / administration & dosage*
Chemical
Reg. No./Substance:
0/Glucocorticoids; 50-24-8/Prednisolone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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