Document Detail

Two newly proposed infectious encephalitis/encephalopathy syndromes.
MedLine Citation:
PMID:  19339128     Owner:  NLM     Status:  MEDLINE    
Two newly proposed infectious encephalitis/encephalopathy syndromes, in which magnetic resonance imaging (MRI) is essential for the diagnosis, have been reviewed. Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) is reported only in East Asian infants, characterized by a febrile seizure (usually >30 min) as the initial neurological symptom on day 1, followed by secondary seizures at day 4 to 6; affected children display variable levels of neurological sequelae. MRI shows no acute abnormality during the first two days; reduced diffusion appears in the frontal or fronto-parietal subcortical white matter during days 3 to 9, then disappears between days 9 and 25. Excitotoxic injury with delayed neuronal death is hypothesized as a possible mechanism based on MR spectroscopic findings. Clinically mild encephalitis/encephalopathy with a reversible splenial lesion (MERS) is characterized by a reversible lesion with homogeneously reduced diffusion in the corpus callosum (at least involving the splenium), sometimes associated with symmetrical white matter lesions. The most common neurological symptom is delirious behavior, followed by consciousness disturbance, and seizures, all of which completely recover within a month. The reason for the transiently reduced diffusion within the lesions is unknown; possibilities that have been postulated include intramyelinic edema, interstitial edema in tightly packed fibers, and a transient inflammatory infiltrate.
Jun-ichi Takanashi
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review     Date:  2009-03-31
Journal Detail:
Title:  Brain & development     Volume:  31     ISSN:  1872-7131     ISO Abbreviation:  Brain Dev.     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-07-06     Completed Date:  2009-09-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7909235     Medline TA:  Brain Dev     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  521-8     Citation Subset:  IM    
Department of Pediatrics, Kameda Medical Center, 929 Higashi-cho, Kamogawa-shi, Chiba 296-8602, Japan.
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MeSH Terms
Brain / metabolism,  pathology
Delirium / diagnosis,  pathology,  therapy
Diagnosis, Differential
Encephalitis / diagnosis*,  pathology,  therapy
Influenza, Human / complications
Seizures / diagnosis,  pathology,  therapy

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