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Miscellaneous Encephalitis
Surjith Vattoth, MD, FRCR; Miral D. Jhaveri, MD; Karen L. Salzman, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Definitions

                • Diffuse brain parenchymal inflammation caused by variety of pathogens, most commonly viruses
                • Location dependent on etiology

              IMAGING

              • General Features

                • CT Findings

                  • MR Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Staging, Grading, & Classification

                            • Gross Pathologic & Surgical Features

                              • Microscopic Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Consider

                                          • Image Interpretation Pearls

                                            Selected References

                                            1. Kramer R et al: Acute flaccid myelitis caused by enterovirus D68: case definitions for use in clinical practice. Eur J Paediatr Neurol. 23(2):235-9, 2019
                                            2. Okumura A et al: Serial MRI findings of acute flaccid myelitis during an outbreak of enterovirus D68 infection in Japan. Brain Dev. 41(5):443-51, 2019
                                            3. Sharma V et al: Emerging trends of Nipah virus: a review. Rev Med Virol. 29(1):e2010, 2019
                                            4. Yoder JA et al: Pediatric acute flaccid paralysis: enterovirus D68-associated anterior myelitis. J Emerg Med. 53(1):e19-e23, 2017
                                            5. Daep CA et al: Flaviviruses, an expanding threat in public health: focus on dengue, West Nile, and Japanese encephalitis virus. J Neurovirol. 20(6):539-60, 2014
                                            6. Goldberg EM et al: Anti-N-methyl-D-aspartate receptor-mediated encephalitis in infants and toddlers: case report and review of the literature. Pediatr Neurol. 50(2):181-4, 2014
                                            7. Griffiths MJ et al: Japanese encephalitis virus infection. Handb Clin Neurol. 123:561-76, 2014
                                            8. Mahan M et al: Neuroimaging of viral infections of the central nervous system. Handb Clin Neurol. 123:149-73, 2014
                                            9. Park A et al: Respiratory syncytial virus-related encephalitis: magnetic resonance imaging findings with diffusion-weighted study. Neuroradiology. 56(2):163-8, 2014
                                            10. Basumatary LJ et al: Clinical and radiological spectrum of Japanese encephalitis. J Neurol Sci. 325(1-2):15-21, 2013
                                            11. Speers DJ et al: Clinical and radiological predictors of outcome for Murray Valley encephalitis. Am J Trop Med Hyg. 88(3):481-9, 2013
                                            12. Watanabe M et al: Mumps virus-associated acute encephalopathy: case report and review of the literature. J Child Neurol. 28(2):243-5, 2013
                                            13. Yoshida T et al: MRI gadolinium enhancement precedes neuroradiological findings in acute necrotizing encephalopathy. Brain Dev. 35(10):921-4, 2013
                                            14. Zeng H et al: Clinical and MRI features of neurological complications after influenza A (H1N1) infection in critically ill children. Pediatr Radiol. 43(9):1182-9, 2013
                                            15. Bale JF Jr: Emerging viral infections. Semin Pediatr Neurol. 19(3):152-7, 2012
                                            16. Parmar H et al: Pediatric intracranial infections. Neuroimaging Clin N Am. 22(4):707-25, 2012
                                            17. Thompson C et al: Encephalitis in children. Arch Dis Child. 97(2):150-61, 2012
                                            18. Handique SK: Viral infections of the central nervous system. Neuroimaging Clin N Am. 21(4):777-94, vii, 2011
                                            19. Reppel M et al: Japanese encephalitis in Western Europe. Clin Neurol Neurosurg. 111(4):373-5, 2009
                                            20. Misra UK et al: The prognostic role of magnetic resonance imaging and single-photon emission computed tomography in viral encephalitis. Acta Radiol. 49(7):827-32, 2008
                                            21. Nagel MA et al: The varicella zoster virus vasculopathies: clinical, CSF, imaging, and virologic features. Neurology. 70(11):853-60, 2008
                                            22. Rumboldt Z: Imaging of topographic viral CNS infections. Neuroimaging Clin N Am. 18(1):85-92; viii, 2008
                                            23. Tavazzi E et al: Varicella zoster virus meningo-encephalo-myelitis in an immunocompetent patient. Neurol Sci. 29(4):279-83, 2008
                                            24. Baskin HJ et al: Neuroimaging of herpesvirus infections in children. Pediatr Radiol. 37(10):949-63, 2007
                                            25. Sejvar JJ et al: Long-term neurological and functional outcome in Nipah virus infection. Ann Neurol. 62(3):235-42, 2007
                                            26. Sarkar N et al: Bilateral intracerebral haemorrhages: an atypical presentation of Japanese encephalitis. J Assoc Physicians India. 53:144-6, 2005
                                            27. Wong SH et al: Murray valley encephalitis mimicking herpes simplex encephalitis. J Clin Neurosci. 12(7):822-4, 2005
                                            28. Emig M et al: Severe West Nile virus disease in healthy adults. Clin Infect Dis. 38(2):289-92, 2004
                                            29. Kennedy PG: Viral encephalitis: causes, differential diagnosis, and management. J Neurol Neurosurg Psychiatry. 75 Suppl 1:i10-5, 2004
                                            30. Lury KM et al: Eastern equine encephalitis: CT and MRI findings in one case. Emerg Radiol. 11(1):46-8, 2004
                                            31. Prakash M et al: Diffusion-weighted MR imaging in Japanese encephalitis. J Comput Assist Tomogr. 28(6):756-61, 2004
                                            32. Laothamatas J et al: MR imaging in human rabies. AJNR Am J Neuroradiol. 24(6):1102-9, 2003
                                            33. 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
                                            34. Majid A et al: Epstein-Barr virus myeloradiculitis and encephalomyeloradiculitis. Brain. 125(Pt 1):159-65, 2002
                                            35. Kleinschmidt-DeMasters BK et al: The expanding spectrum of herpesvirus infections of the nervous system. Brain Pathol. 11(4):440-51, 2001
                                            36. 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
                                            37. Deresiewicz RL et al: Clinical and neuroradiographic manifestations of eastern equine encephalitis. N Engl J Med. 336(26):1867-74, 1997
                                            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

                                                      • Diagnostic Checklist

                                                        TERMINOLOGY

                                                        • Definitions

                                                          • Diffuse brain parenchymal inflammation caused by variety of pathogens, most commonly viruses
                                                          • Location dependent on etiology

                                                        IMAGING

                                                        • General Features

                                                          • CT Findings

                                                            • MR Findings

                                                              • Imaging Recommendations

                                                                DIFFERENTIAL DIAGNOSIS

                                                                  PATHOLOGY

                                                                  • General Features

                                                                    • Staging, Grading, & Classification

                                                                      • Gross Pathologic & Surgical Features

                                                                        • Microscopic Features

                                                                          CLINICAL ISSUES

                                                                          • Presentation

                                                                            • Demographics

                                                                              • Natural History & Prognosis

                                                                                • Treatment

                                                                                  DIAGNOSTIC CHECKLIST

                                                                                  • Consider

                                                                                    • Image Interpretation Pearls

                                                                                      Selected References

                                                                                      1. Kramer R et al: Acute flaccid myelitis caused by enterovirus D68: case definitions for use in clinical practice. Eur J Paediatr Neurol. 23(2):235-9, 2019
                                                                                      2. Okumura A et al: Serial MRI findings of acute flaccid myelitis during an outbreak of enterovirus D68 infection in Japan. Brain Dev. 41(5):443-51, 2019
                                                                                      3. Sharma V et al: Emerging trends of Nipah virus: a review. Rev Med Virol. 29(1):e2010, 2019
                                                                                      4. Yoder JA et al: Pediatric acute flaccid paralysis: enterovirus D68-associated anterior myelitis. J Emerg Med. 53(1):e19-e23, 2017
                                                                                      5. Daep CA et al: Flaviviruses, an expanding threat in public health: focus on dengue, West Nile, and Japanese encephalitis virus. J Neurovirol. 20(6):539-60, 2014
                                                                                      6. Goldberg EM et al: Anti-N-methyl-D-aspartate receptor-mediated encephalitis in infants and toddlers: case report and review of the literature. Pediatr Neurol. 50(2):181-4, 2014
                                                                                      7. Griffiths MJ et al: Japanese encephalitis virus infection. Handb Clin Neurol. 123:561-76, 2014
                                                                                      8. Mahan M et al: Neuroimaging of viral infections of the central nervous system. Handb Clin Neurol. 123:149-73, 2014
                                                                                      9. Park A et al: Respiratory syncytial virus-related encephalitis: magnetic resonance imaging findings with diffusion-weighted study. Neuroradiology. 56(2):163-8, 2014
                                                                                      10. Basumatary LJ et al: Clinical and radiological spectrum of Japanese encephalitis. J Neurol Sci. 325(1-2):15-21, 2013
                                                                                      11. Speers DJ et al: Clinical and radiological predictors of outcome for Murray Valley encephalitis. Am J Trop Med Hyg. 88(3):481-9, 2013
                                                                                      12. Watanabe M et al: Mumps virus-associated acute encephalopathy: case report and review of the literature. J Child Neurol. 28(2):243-5, 2013
                                                                                      13. Yoshida T et al: MRI gadolinium enhancement precedes neuroradiological findings in acute necrotizing encephalopathy. Brain Dev. 35(10):921-4, 2013
                                                                                      14. Zeng H et al: Clinical and MRI features of neurological complications after influenza A (H1N1) infection in critically ill children. Pediatr Radiol. 43(9):1182-9, 2013
                                                                                      15. Bale JF Jr: Emerging viral infections. Semin Pediatr Neurol. 19(3):152-7, 2012
                                                                                      16. Parmar H et al: Pediatric intracranial infections. Neuroimaging Clin N Am. 22(4):707-25, 2012
                                                                                      17. Thompson C et al: Encephalitis in children. Arch Dis Child. 97(2):150-61, 2012
                                                                                      18. Handique SK: Viral infections of the central nervous system. Neuroimaging Clin N Am. 21(4):777-94, vii, 2011
                                                                                      19. Reppel M et al: Japanese encephalitis in Western Europe. Clin Neurol Neurosurg. 111(4):373-5, 2009
                                                                                      20. Misra UK et al: The prognostic role of magnetic resonance imaging and single-photon emission computed tomography in viral encephalitis. Acta Radiol. 49(7):827-32, 2008
                                                                                      21. Nagel MA et al: The varicella zoster virus vasculopathies: clinical, CSF, imaging, and virologic features. Neurology. 70(11):853-60, 2008
                                                                                      22. Rumboldt Z: Imaging of topographic viral CNS infections. Neuroimaging Clin N Am. 18(1):85-92; viii, 2008
                                                                                      23. Tavazzi E et al: Varicella zoster virus meningo-encephalo-myelitis in an immunocompetent patient. Neurol Sci. 29(4):279-83, 2008
                                                                                      24. Baskin HJ et al: Neuroimaging of herpesvirus infections in children. Pediatr Radiol. 37(10):949-63, 2007
                                                                                      25. Sejvar JJ et al: Long-term neurological and functional outcome in Nipah virus infection. Ann Neurol. 62(3):235-42, 2007
                                                                                      26. Sarkar N et al: Bilateral intracerebral haemorrhages: an atypical presentation of Japanese encephalitis. J Assoc Physicians India. 53:144-6, 2005
                                                                                      27. Wong SH et al: Murray valley encephalitis mimicking herpes simplex encephalitis. J Clin Neurosci. 12(7):822-4, 2005
                                                                                      28. Emig M et al: Severe West Nile virus disease in healthy adults. Clin Infect Dis. 38(2):289-92, 2004
                                                                                      29. Kennedy PG: Viral encephalitis: causes, differential diagnosis, and management. J Neurol Neurosurg Psychiatry. 75 Suppl 1:i10-5, 2004
                                                                                      30. Lury KM et al: Eastern equine encephalitis: CT and MRI findings in one case. Emerg Radiol. 11(1):46-8, 2004
                                                                                      31. Prakash M et al: Diffusion-weighted MR imaging in Japanese encephalitis. J Comput Assist Tomogr. 28(6):756-61, 2004
                                                                                      32. Laothamatas J et al: MR imaging in human rabies. AJNR Am J Neuroradiol. 24(6):1102-9, 2003
                                                                                      33. 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
                                                                                      34. Majid A et al: Epstein-Barr virus myeloradiculitis and encephalomyeloradiculitis. Brain. 125(Pt 1):159-65, 2002
                                                                                      35. Kleinschmidt-DeMasters BK et al: The expanding spectrum of herpesvirus infections of the nervous system. Brain Pathol. 11(4):440-51, 2001
                                                                                      36. 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
                                                                                      37. Deresiewicz RL et al: Clinical and neuroradiographic manifestations of eastern equine encephalitis. N Engl J Med. 336(26):1867-74, 1997