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Pediatrics
Diagnosis
Brain
Metabolic, Infectious, and Inflammatory Disorders
Acute Encephalitis
Acute Encephalitis
Blaise V. Jones, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Definitions

              • Acute brain inflammation caused by infectious agents, most commonly viruses
              • Noninfectious (autoimmune) brain inflammation

            IMAGING

            • General Features

              • CT Findings

                • MR Findings

                  • Imaging Recommendations

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        • Gross Pathologic & Surgical Features

                          • Microscopic Features

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Consider

                                      • Image Interpretation Pearls

                                        Selected References

                                        1. Lindan CE et al: Neuroimaging manifestations in children with SARS-CoV-2 infection: a multinational, multicentre collaborative study. Lancet Child Adolesc Health. 5(3):167-77, 2020
                                        2. Starkey J et al: Cytotoxic lesions of the corpus callosum that show restricted diffusion: mechanisms, causes, and manifestations. Radiographics. 37(2):562-76, 2017
                                        3. Gagnon MM et al: Limbic encephalitis associated with GAD65 antibodies: brief review of the relevant literature. Can J Neurol Sci. 43(4):486-93, 2016
                                        4. Bajaj M et al: Clinical and neuroimaging findings in neonatal herpes simplex virus infection. J Pediatr. 165(2):404-7.e1, 2014
                                        5. To TM et al: Insights into pediatric herpes simplex encephalitis from a cohort of 21 children from the California Encephalitis Project, 1998-2011. Pediatr Infect Dis J. 33(12):1287-8, 2014
                                        6. Crapp S et al: Rocky Mountain spotted fever: 'starry sky' appearance with diffusion-weighted imaging in a child. Pediatr Radiol. 42(4):499-502, 2011
                                        7. Ito S et al: Transient splenial lesion of the corpus callosum in H1N1 influenza virus-associated encephalitis/encephalopathy. Intern Med. 50(8):915-8, 2011
                                        8. Yadav S et al: Acute necrotizing encephalopathy. Indian J Pediatr. 77(3):307-9, 2010
                                        9. Reppel M et al: Japanese encephalitis in Western Europe. Clin Neurol Neurosurg. 111(4):373-5, 2009
                                        10. Nagel MA et al: The varicella zoster virus vasculopathies: clinical, CSF, imaging, and virologic features. Neurology. 70(11):853-60, 2008
                                        11. Skelton BW et al: Acute necrotizing encephalopathy of childhood: typical findings in an atypical disease. Pediatr Radiol. 38(7):810-3, 2008
                                        12. Tavazzi E et al: Varicella zoster virus meningo-encephalo-myelitis in an immunocompetent patient. Neurol Sci. 29(4):279-83, 2008
                                        13. Baskin HJ et al: Neuroimaging of herpesvirus infections in children. Pediatr Radiol. 37(10):949-63, 2007
                                        14. Sejvar JJ et al: Long-term neurological and functional outcome in Nipah virus infection. Ann Neurol. 62(3):235-42, 2007
                                        15. Wong AM et al: Acute necrotizing encephalopathy of childhood: correlation of MR findings and clinical outcome. AJNR Am J Neuroradiol. 27(9):1919-23, 2006
                                        16. Sarkar N et al: Bilateral intracerebral haemorrhages: an atypical presentation of Japanese encephalitis. J Assoc Physicians India. 53:144-6, 2005
                                        17. Wong SH et al: Murray valley encephalitis mimicking herpes simplex encephalitis. J Clin Neurosci. 12(7):822-4, 2005
                                        18. Emig M et al: Severe West Nile virus disease in healthy adults. Clin Infect Dis. 38(2):289-92, 2004
                                        19. Kennedy PG: Viral encephalitis: causes, differential diagnosis, and management. J Neurol Neurosurg Psychiatry. 75 Suppl 1:i10-5, 2004
                                        20. Lury KM et al: Eastern equine encephalitis: CT and MRI findings in one case. Emerg Radiol. 11(1):46-8, 2004
                                        21. Prakash M et al: Diffusion-weighted MR imaging in Japanese encephalitis. J Comput Assist Tomogr. 28(6):756-61, 2004
                                        22. Laothamatas J et al: MR imaging in human rabies. AJNR Am J Neuroradiol. 24(6):1102-9, 2003
                                        23. Calli C et al: Proton MR spectroscopy in the diagnosis and differentiation of encephalitis from other mimicking lesions. J Neuroradiol. 29(1):23-8, 2002
                                        24. Wasay M et al: St Louis encephalitis: a review of 11 cases in a 1995 Dallas, Tex, epidemic. Arch Neurol. 57(1):114-8, 2000
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Terminology

                                          • Imaging

                                            • Top Differential Diagnoses

                                              • Pathology

                                                • Clinical Issues

                                                  TERMINOLOGY

                                                  • Definitions

                                                    • Acute brain inflammation caused by infectious agents, most commonly viruses
                                                    • Noninfectious (autoimmune) brain inflammation

                                                  IMAGING

                                                  • General Features

                                                    • CT Findings

                                                      • MR Findings

                                                        • Imaging Recommendations

                                                          DIFFERENTIAL DIAGNOSIS

                                                            PATHOLOGY

                                                            • General Features

                                                              • Gross Pathologic & Surgical Features

                                                                • Microscopic Features

                                                                  CLINICAL ISSUES

                                                                  • Presentation

                                                                    • Demographics

                                                                      • Natural History & Prognosis

                                                                        • Treatment

                                                                          DIAGNOSTIC CHECKLIST

                                                                          • Consider

                                                                            • Image Interpretation Pearls

                                                                              Selected References

                                                                              1. Lindan CE et al: Neuroimaging manifestations in children with SARS-CoV-2 infection: a multinational, multicentre collaborative study. Lancet Child Adolesc Health. 5(3):167-77, 2020
                                                                              2. Starkey J et al: Cytotoxic lesions of the corpus callosum that show restricted diffusion: mechanisms, causes, and manifestations. Radiographics. 37(2):562-76, 2017
                                                                              3. Gagnon MM et al: Limbic encephalitis associated with GAD65 antibodies: brief review of the relevant literature. Can J Neurol Sci. 43(4):486-93, 2016
                                                                              4. Bajaj M et al: Clinical and neuroimaging findings in neonatal herpes simplex virus infection. J Pediatr. 165(2):404-7.e1, 2014
                                                                              5. To TM et al: Insights into pediatric herpes simplex encephalitis from a cohort of 21 children from the California Encephalitis Project, 1998-2011. Pediatr Infect Dis J. 33(12):1287-8, 2014
                                                                              6. Crapp S et al: Rocky Mountain spotted fever: 'starry sky' appearance with diffusion-weighted imaging in a child. Pediatr Radiol. 42(4):499-502, 2011
                                                                              7. Ito S et al: Transient splenial lesion of the corpus callosum in H1N1 influenza virus-associated encephalitis/encephalopathy. Intern Med. 50(8):915-8, 2011
                                                                              8. Yadav S et al: Acute necrotizing encephalopathy. Indian J Pediatr. 77(3):307-9, 2010
                                                                              9. Reppel M et al: Japanese encephalitis in Western Europe. Clin Neurol Neurosurg. 111(4):373-5, 2009
                                                                              10. Nagel MA et al: The varicella zoster virus vasculopathies: clinical, CSF, imaging, and virologic features. Neurology. 70(11):853-60, 2008
                                                                              11. Skelton BW et al: Acute necrotizing encephalopathy of childhood: typical findings in an atypical disease. Pediatr Radiol. 38(7):810-3, 2008
                                                                              12. Tavazzi E et al: Varicella zoster virus meningo-encephalo-myelitis in an immunocompetent patient. Neurol Sci. 29(4):279-83, 2008
                                                                              13. Baskin HJ et al: Neuroimaging of herpesvirus infections in children. Pediatr Radiol. 37(10):949-63, 2007
                                                                              14. Sejvar JJ et al: Long-term neurological and functional outcome in Nipah virus infection. Ann Neurol. 62(3):235-42, 2007
                                                                              15. Wong AM et al: Acute necrotizing encephalopathy of childhood: correlation of MR findings and clinical outcome. AJNR Am J Neuroradiol. 27(9):1919-23, 2006
                                                                              16. Sarkar N et al: Bilateral intracerebral haemorrhages: an atypical presentation of Japanese encephalitis. J Assoc Physicians India. 53:144-6, 2005
                                                                              17. Wong SH et al: Murray valley encephalitis mimicking herpes simplex encephalitis. J Clin Neurosci. 12(7):822-4, 2005
                                                                              18. Emig M et al: Severe West Nile virus disease in healthy adults. Clin Infect Dis. 38(2):289-92, 2004
                                                                              19. Kennedy PG: Viral encephalitis: causes, differential diagnosis, and management. J Neurol Neurosurg Psychiatry. 75 Suppl 1:i10-5, 2004
                                                                              20. Lury KM et al: Eastern equine encephalitis: CT and MRI findings in one case. Emerg Radiol. 11(1):46-8, 2004
                                                                              21. Prakash M et al: Diffusion-weighted MR imaging in Japanese encephalitis. J Comput Assist Tomogr. 28(6):756-61, 2004
                                                                              22. Laothamatas J et al: MR imaging in human rabies. AJNR Am J Neuroradiol. 24(6):1102-9, 2003
                                                                              23. Calli C et al: Proton MR spectroscopy in the diagnosis and differentiation of encephalitis from other mimicking lesions. J Neuroradiol. 29(1):23-8, 2002
                                                                              24. Wasay M et al: St Louis encephalitis: a review of 11 cases in a 1995 Dallas, Tex, epidemic. Arch Neurol. 57(1):114-8, 2000