Document Detail

Clinical and neuroradiographic manifestations of eastern equine encephalitis.
MedLine Citation:
PMID:  9197215     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Eastern equine encephalitis occurs principally along the east and Gulf coasts of the United States. Recognition of the neuroradiographic manifestations of eastern equine encephalitis could hasten the diagnosis of the illness and speed the response to index cases. METHODS: We reviewed all cases of eastern equine encephalitis reported in the United States between 1988 and 1994. The records of 36 patients were studied, along with 57 computed tomographic (CT) scans and 23 magnetic resonance imaging (MRI) scans from 33 patients. RESULTS: The mortality rate was 36 percent, and 35 percent of the survivors were moderately or severely disabled. Neuroradiographic abnormalities were common and best visualized by MRI. Among the patients for whom MRI scans were available, the results were abnormal for all eight comatose patients as well as for all three noncomatose patients who subsequently became comatose. The CT results were abnormal in 21 of 32 patients with readable scans. The abnormal findings included focal lesions in the basal ganglia (found in 71 percent of patients on MRI, and in 56 percent on CT), thalami (found in 71 percent on MRI and in 25 percent on CT), and brain stem (found in 43 percent on MRI and in 9 percent on CT). Cortical lesions, meningeal enhancement, and periventricular white-matter changes were less common. The presence of large radiographic lesions did not predict a poor outcome, but either high cerebrospinal fluid white-cell counts or severe hyponatremia did. CONCLUSIONS: Eastern equine encephalitis produces focal radiographic signs. The characteristic early involvement of the basal ganglia and thalami distinguish this illness from herpes simplex encephalitis. MRI is a sensitive technique to identify the characteristic early radiographic manifestations of this viral encephalitis.
R L Deresiewicz; S J Thaler; L Hsu; A A Zamani
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The New England journal of medicine     Volume:  336     ISSN:  0028-4793     ISO Abbreviation:  N. Engl. J. Med.     Publication Date:  1997 Jun 
Date Detail:
Created Date:  1997-06-26     Completed Date:  1997-06-26     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0255562     Medline TA:  N Engl J Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1867-74     Citation Subset:  AIM; IM    
Infectious Disease Division, Brigham and Women's Hospital and Harvard Medical School, Boston, USA.
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MeSH Terms
Aged, 80 and over
Analysis of Variance
Central Nervous System / pathology*,  radiography
Child, Preschool
Encephalitis Virus, Eastern Equine*
Encephalomyelitis, Equine / diagnosis*,  mortality,  physiopathology
Magnetic Resonance Imaging
Middle Aged
Statistics, Nonparametric
Survival Rate
Tomography, X-Ray Computed
United States / epidemiology
Comment In:
N Engl J Med. 1997 Nov 6;337(19):1393-4   [PMID:  9380097 ]

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

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