A girl with acute encephalitis followed by acute cerebellitis/cerebellopathy.

Abstract:

OBJECTIVE:The purpose of this study is to bring attention to a case of acute encephalitis not concurrent with acute cerebellitis. CASE PRESENTATION:Five days after onset of common cold symptoms, a 17-months-old girl suffered convulsions, vomiting and respiratory arrest. On exam, she had pharyngeal inflammation, brisk deep tendon reflexes, respiratory acidosis, leukocytosis, negative rapid antigen tests, and segmental pneumonia. Brain CT and MRI/MRA were negative, and EEG was consistent with acute encephalitis. Following hypothermic therapy, methylprednisolone pulse therapy and cefotaxime, she recovered. Four days after discharge, she sustained limb and truncal ataxia associated with normal EEG, followed by bilateral intention tremor. Blood and CSF chemistry and cell counts were normal. Brain MRI revealed high intensity signals in the dentate nuclei and enhancement in the cerebellar white matter, suggestive of acute cerebellitis/cerebellopathy. SPECT imaging showed reduced blood flow in the cerebellum, right thalamus and brain stem. Following short-term administration of g-globulin and prednisolone, she regained her ability to sit and, eventually, to walk. Four months after initial presentation, her brain MRI was normal. No relapse has occurred in 5 years. CONCLUSIONS:The uncommon sequential development of acute encephalitis followed by acute cerebellitis suggests an immune-mediated cerebellar ataxia.

authors

Imataka G,Wake K,Yoshihara S

doi

10.26355/eurrev_202010_23430

subject

Has Abstract

pub_date

2020-10-01 00:00:00

pages

10708-10711

issue

20

eissn

1128-3602

issn

2284-0729

journal_volume

24

pub_type

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