Neuroimaging in Japanese encephalitis and their correlation with clinical profile in pediatric patients

Abstract

Introduction: Japanese encephalitis is a major public health problem in Indian subcontinent. Regardless of all advances in prompt diagnosis of JE, it may be difficult to differentiate JE from other viral encephalitis. Aim: This study was done to know the topographic patterns of CT and MRI abnormalities in JE encephalitis. Methodology: This retrospective observational study was done in children 1-15 years of age who suffered from JE encephalitis diagnosed by MAC-ELISA and in whom CT/MRI was done. Total 25 patients were enrolled. There CT/MRI findings were analysed and correlated with clinical features. Results: The finding were principally seen in thalamic (40%; n=10) and basal ganglia (24%; n=6) in the form of hypo densities. Similar forms of lesions were also found in cortical region, Frontal=2 patients, parietal = 6 patients, temporal = 7 patients and occipital = 1 patient. MRI was done in eleven patients. Our MRI findings were also in correlation with CT findings with most common being thalamic (n=10) and basal ganglia (n=5). Temporal (n=4), parietal (n=3) and occipital (n=2) lobe changes. Conclusions: The imaging findings on CT and MR imaging evidence the pathologic changes. Majority of lesions on CT/MRI were in thalamus and basal ganglia, but in some cases cortical regions were also involved. Temporal involvement, which was previously a reflection of Herpes encephalitis on CT/MRI, can also be seen in JE encephalitis.