Acute Transverse Myelitis (Ascending Myelitis) as the Initial Manifestation of Japanese Encephalitis: A Rare Presentation
Japanese encephalitis, an inflammatory brain disease prevalent in Southeast Asia, usually presented with fever, headache, convulsions, brain stem signs with pyramidal and extrapyramidal features, and altered sensorium. Acute transverse myelitis, as the initial manifestation of Japanese encephalitis,...
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| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2013-01-01
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| Series: | Case Reports in Infectious Diseases |
| Online Access: | http://dx.doi.org/10.1155/2013/487659 |
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| author | Varshney Ankur Nandan Kumar Nilesh Behera Dibyaranjan Tiwari Ashutosh Anand Ravi Anand Arvind |
| author_facet | Varshney Ankur Nandan Kumar Nilesh Behera Dibyaranjan Tiwari Ashutosh Anand Ravi Anand Arvind |
| author_sort | Varshney Ankur Nandan |
| collection | DOAJ |
| description | Japanese encephalitis, an inflammatory brain disease prevalent in Southeast Asia, usually presented with fever, headache, convulsions, brain stem signs with pyramidal and extrapyramidal features, and altered sensorium. Acute transverse myelitis, as the initial manifestation of Japanese encephalitis, is an unusual manifestation and is seldom reported. We hereby report a case of 13-year-old adolescent boy who presented to us with fever and acute onset paraparesis with urinary retention initially, progressing to quadriparesis and then followed by headache and altered sensorium. Brain MRI revealed bilateral basal ganglia that were grossly swollen with vasogenic edema tracking along internal capsule and midbrain. Adjacent ventrolateral thalamus and internal capsule also showed mild abnormal intensities. Spinal screening showed abnormal cord intensities in entire cord with gross edema in cervical and conus regions. He had elevated IgM titres against JE virus in cerebrospinal fluid. The patient was treated conservatively along with intravenous methyl prednisolone for 5 days. He regained near normal power at 3 months in followup, but hesitancy, dysarthria, and slowness of movement still persisted. To conclude, a young boy presenting with ATM in an endemic region of JE, then a possibility of Japanese encephalitis, should be sought by clinicians as early use of immunomodulator shows survival benefit. |
| format | Article |
| id | doaj-art-dd4868e25e4547929965ab32ead85604 |
| institution | Kabale University |
| issn | 2090-6625 2090-6633 |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Infectious Diseases |
| spelling | doaj-art-dd4868e25e4547929965ab32ead856042025-02-03T01:29:05ZengWileyCase Reports in Infectious Diseases2090-66252090-66332013-01-01201310.1155/2013/487659487659Acute Transverse Myelitis (Ascending Myelitis) as the Initial Manifestation of Japanese Encephalitis: A Rare PresentationVarshney Ankur Nandan0Kumar Nilesh1Behera Dibyaranjan2Tiwari Ashutosh3Anand Ravi4Anand Arvind5IMS BHU, Varanasi, IndiaIMS BHU, Varanasi, IndiaIMS BHU, Varanasi, IndiaIMS BHU, Varanasi, IndiaIMS BHU, Varanasi, IndiaIMS BHU, Varanasi, IndiaJapanese encephalitis, an inflammatory brain disease prevalent in Southeast Asia, usually presented with fever, headache, convulsions, brain stem signs with pyramidal and extrapyramidal features, and altered sensorium. Acute transverse myelitis, as the initial manifestation of Japanese encephalitis, is an unusual manifestation and is seldom reported. We hereby report a case of 13-year-old adolescent boy who presented to us with fever and acute onset paraparesis with urinary retention initially, progressing to quadriparesis and then followed by headache and altered sensorium. Brain MRI revealed bilateral basal ganglia that were grossly swollen with vasogenic edema tracking along internal capsule and midbrain. Adjacent ventrolateral thalamus and internal capsule also showed mild abnormal intensities. Spinal screening showed abnormal cord intensities in entire cord with gross edema in cervical and conus regions. He had elevated IgM titres against JE virus in cerebrospinal fluid. The patient was treated conservatively along with intravenous methyl prednisolone for 5 days. He regained near normal power at 3 months in followup, but hesitancy, dysarthria, and slowness of movement still persisted. To conclude, a young boy presenting with ATM in an endemic region of JE, then a possibility of Japanese encephalitis, should be sought by clinicians as early use of immunomodulator shows survival benefit.http://dx.doi.org/10.1155/2013/487659 |
| spellingShingle | Varshney Ankur Nandan Kumar Nilesh Behera Dibyaranjan Tiwari Ashutosh Anand Ravi Anand Arvind Acute Transverse Myelitis (Ascending Myelitis) as the Initial Manifestation of Japanese Encephalitis: A Rare Presentation Case Reports in Infectious Diseases |
| title | Acute Transverse Myelitis (Ascending Myelitis) as the Initial Manifestation of Japanese Encephalitis: A Rare Presentation |
| title_full | Acute Transverse Myelitis (Ascending Myelitis) as the Initial Manifestation of Japanese Encephalitis: A Rare Presentation |
| title_fullStr | Acute Transverse Myelitis (Ascending Myelitis) as the Initial Manifestation of Japanese Encephalitis: A Rare Presentation |
| title_full_unstemmed | Acute Transverse Myelitis (Ascending Myelitis) as the Initial Manifestation of Japanese Encephalitis: A Rare Presentation |
| title_short | Acute Transverse Myelitis (Ascending Myelitis) as the Initial Manifestation of Japanese Encephalitis: A Rare Presentation |
| title_sort | acute transverse myelitis ascending myelitis as the initial manifestation of japanese encephalitis a rare presentation |
| url | http://dx.doi.org/10.1155/2013/487659 |
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