Journal of Shandong University (Health Sciences) ›› 2018, Vol. 56 ›› Issue (2): 23-27.doi: 10.6040/j.issn.1671-7554.0.2017.1013

Previous Articles    

Clinical and radiological features of 36 adult patients with epidemic encephalitis B

MIAO Meng1, JIA Guoyong2, LIU Ying2, WANG Cuilan2   

  1. 1. Department of Neurology, Qilu Hospital of Shandong University(Qingdao), Qingdao 266035, Shandong, China;
    2. Department of Neurology, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China
  • Published:2022-09-28

PDF (PC)

52

Abstract: Objective To investigate clinical, cerebrospinal fluid(CSF)and radiological features of adult patients with epidemic encephalitis B. Methods The data were collected from 36 adult patients with epidemic encephalitis B who were diagnosed and treated in Qilu Hospital of Shandong University, from August to September in 2013. Results The patients with epidemic encephalitis B presented with fever(100%), consciousness and cognitive impairment, headache, nausea, vomiting(86.1%), and meningeal irritation(80.6%). Parkinson-like symptoms(30.6%)and seizure disorders(27.8%)were common. The IgM antibody against epidemic encephalitis B in serum and CSF was found. A total of 13 patients(54.2%)suffered intracranial hypertension, 22 patients displayed abnormal CSF cytology reaction, 16 patients(72.7%)displayed mixed-cell reaction, 6 patients(27.3%)appeared lymphocyte reaction. Protein content of 17 patients(70.8%)increased, IgG of 21 patients(87.5%)increased, IgA of 19 patients(79.2%)increased, and IgM of 23 patients(95.8%)increased. A total of 22 patients(61.1%)underwent brain MRI, 17 patients(47.2%)underwent brain CT. Neural damages displayed in thalamus(13 cases, 59.1%), midbrain(4 cases, 18.2%), basal ganglia(3 cases, 13.6%), hippocampus(3 cases, 13.6%)and other brain lobes(5 cases, 22.7%). A total of 4 patients(18.2%)were normal. Conclusion The patients with epidemic encephalitis B present acute encephalitic syndrome, 山 东 大 学 学 报 (医 学 版)56卷2期 -苗萌,等.36例成人流行性乙型脑炎临床分析和影像学特点 \=-accompanied with extrapyramid symptoms. The important features of CSF present the significant increase of the proportion of neutrophils and the prolonged duration of mixed-cell reaction. Neural damages commonly appear in thalamus.

Key words: Epidemic encephalitis B, Clinical features, Cerebrospinal fluid, Brain MRI, Adults

CLC Number: 

  • R512.32
[1] Connor B, Bunn WB. The changing epidemiology of Japanese encephalitis and new data: the implications for new recommendations for Japanese encephalitis vaccine[J]. Trop Dis Travel Med Vaccines, 2017, 3(1):14. doi: 10.1186/s40794-017-0057-x. eCollection, 2017.
[2] Misra UK, Kalita J. Overview: Japanese encephalitis[J]. Prog Neurobiol, 2010, 91(2):108-120.
[3] Basumatary LJ, Raja D, Bhuyan D, et al. Clinical and radiological spectrum of Japanese encephalitis[J]. J Neurol Sci, 2013, 325(1):15-21.
[4] Misra UK, Kalita J. Spectrum of movement disorders in encephalitis[J]. J Neurol, 2010, 257(12):2052-2058.
[5] Michael BD, Solomon T. Seizures and encephalitis: clinical features, management, and potential pathophysiologic mechanisms[J]. Epilepsia, 2012, 53(s4):63-71.
[6] Dutta K, Mishra MK, Nazmi A, et al. Minocycline differentially modulates macrophage mediated peripheral immune response following Japanese encephalitis virus infection[J]. Immunobiology, 2010, 215(11):884-893.
[7] Kaushik DK, Gupta M, Basu A. Microglial response to viral challenges: every silver lining comes with a cloud[J]. Front Biosci(Landmark Ed), 2011, 16:2187-2205.
[8] Lannes N, Summerfield A, Filgueira L. Regulation of inflammation in Japanese encephalitis[J]. J Neuroinflammation, 2017, 14(1):158. doi:10.1186/s12974-017-0931-5.
[9] Nazmi A, Dutta K, Basu A. RIG-I mediates innate immune response in mouse neurons following Japanese encephalitis virus infection[J]. PLoS one, 2011, 6(6): e21761. doi: 10.1371/journal.pone.0021761.
[10] 鲁明,刘平,岳毅勇,等. 流行性乙型脑炎的脑脊液细胞学观察[J]. 中国实用神经疾病杂志, 2007, 10(5):128-129.
[11] 许自强,黄刚,刘世民,等. 脑脊液细胞学呈混合细胞反应的临床意义[J]. 南昌大学学报(医学版),2010,50(2):44-47. XU Ziqiang, HUANG Gang, LIU Shimin, et al. The clinical significance of cerebrospinal fluid cytology presenting mixed cell reaction[J]. Journal of Nanchang University(Medical Science), 2010, 50(2):44-47.
[12] 杜志宏,彭炳蔚,李小晶,等. 流行性乙型脑炎22例临床及影像学特征分析[J]. 中国实用儿科杂志,2013,27(11):852-855. DU Zhihong, PENG Bingwei, LI Xiaojing, et al. Clinical and radiological characteristics of 22 epidemic encephalitis B cases[J]. Chinese Journal of Practical Pediatrics, 2013, 27(11): 852-855.
[13] Misra UK, Kalita J, Phadke RV, et al. Usefulness of various MRI sequences in the diagnosis of viral encephalitis[J]. Acta Trop, 2010, 116(3): 206-211.
[14] Kalita J, Misra UK. Comparison of CT scan and MRI findings in the diagnosis of Japanese encephalitis[J]. J Neurol Sci, 2000, 174(1): 3-8.
[15] 李瑾,董利昭,陈一冰,等. 急性单纯疱疹病毒性脑炎及脑膜炎患者临床特征及预后分析[J]. 中国全科医学,2017,20(8):992-996. LI Jin, DONG Lizhao, CHEN Yibing, et al. Clinical features and prognosis of acute herpes simplex viral encephalitis and meningitis patients[J]. Chinese General Practice, 2017, 20(8):992-996.
[16] Sunwoo JS, Lee ST, Jung KH, et al. Clinical characteristics of severe Japanese encephalitis: a case series from South Korea[J]. Am J Trop Med Hyg, 2017, 97(2):369-375.
[17] Griffiths MJ, Turtle L, Solomon T. Japanese encephalitis virus infection[J]. Handb Clin Neurol, 2014, 123(1):561-576.
[18] Lewthwaite P, Shankar MV, Tio PH, et al. Evaluation of two commercially available ELISAs for the diagnosis of Japanese encephalitis applied to field samples[J]. Trop Med Int Health, 2010, 15(7):811-818.
[19] Solomon T, Dung NM, Kneen R, et al. Seizures and raised intracranial pressure in Vietnamese patients with Japanese encephalitis[J]. Brain, 2002, 125(5):1084-1093.
[20] Misra UK, Kalita J, Srivastava M. Prognosis of Japanese encephalitis: a multivariate analysis[J]. J Neurol Sci, 1998, 161(2): 143-147.
[1] XU Xiaoming, KONG Yiting, LIU Chuan, MING Ying, KUANG Li. Research progress of suicide warning systems for adolescents and young adults [J]. Journal of Shandong University (Health Sciences), 2022, 60(2): 69-74.
[2] YOU Xueting, TIAN Xingsong. Analysis of clinicopathological characteristics of 3 514 cases of breast cancer over 9 years [J]. Journal of Shandong University (Health Sciences), 2021, 59(1): 49-54.
[3] LU Zilong, FU Zhentao, DU Enqing, XU Chunxiao, ZHANG Jiyu, CHU Jie, ZHANG Bingyin, WU Bingyi, GUO Xiaolei. A study on self-reported health-adjusted life expectancy of adults in Shandong Province, 2018 [J]. Journal of Shandong University (Health Sciences), 2020, 1(9): 83-88.
[4] CAO Aihua, DUAN Chunhong, QIU Bingping, LU Ling, LI Keliang, LIU Xuegong, ZHOU Zhiyuan, SUN Jianhua, JU Xiuli. Epidemiological and clinical characteristics of children infected with SARS-CoV-2 in Shandong Province [J]. Journal of Shandong University (Health Sciences), 2020, 58(6): 34-40.
[5] WANG Huasheng, OU Renjie, WANG Mo, BAI Longzhen,LI Yingjie, SUN Chao, WANG Yongmei. Clinical features of 9 cases of cryptogenic organizing pneumonia and literature review [J]. Journal of Shandong University (Health Sciences), 2020, 58(1): 81-86.
[6] LI Fan, SHAO Jianhua, ZHAO Hongyu, DOU Chunhui, LÜ Yahui, LI Daqi. Clinical features and prognosis of adult secondary hemophagocytic syndrome: an analysis of 32 cases [J]. Journal of Shandong University (Health Sciences), 2019, 57(12): 62-67.
[7] GUO Xuejie, YANG Xiaorong, SANG Shaowei, LIU Bingyan, LÜ Ming. Factors influencing awareness of hypertension among rural adults in Pingyin County of Jinan City [J]. Journal of Shandong University (Health Sciences), 2019, 57(12): 103-109.
[8] ZHANG Hua, ZHUANG Xia, LIU Zhendong, DIAO Yutao, DU Jiachen, CUI Yi. Evaluation of the effects of high blood pressure on white matter lesion in young adults using diffusion tensor imaging [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(5): 56-60.
[9] YIN Xiaofang, GE Haibo. Epidemiological features of inpatients suffered from pulmonary tuberculosis with diabetes mellitus [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(1): 58-61.
[10] WANG Chunlai, XU Shujun, WANG Hongliang, SHANG Jingrui. Neuroendoscopic repair of traumatic cerebrospinal fluid rhinorrhea [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2015, 53(3): 69-72.
[11] SUN Ying, YU Jing, WEI Junmin, FAN Cong, WANG Xiuwen, GAO Peng, JIANG Liyu, MA Tingting. Clinical and pathological characteristics of breast carcinoma in women aged 35 years or younger [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2014, 52(7): 71-74.
[12] LIU Pan-pan1,2, XIE Zhi-wei1,2, LI Guo-ju2,3, GUO Jing1,2. Anthropometric analysis of the morphology of mandibular body in adults of Han nationality with average skeletal pattern [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2013, 51(12): 95-99.
[13] CAO Wei, XIN Tao, LIU Wei, ZHANG Yong-chao. Clinical analysis of latent cerebrospinal fluid leakage after cerebllopontine angle tumor surgery [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2013, 51(12): 78-81.
[14] LIANG Ji-ye1,2, WANG Cui-lan1, DENG Xiao-mei1. Detection of soluble Fas in patients with herpes simplex encephalitis [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2013, 51(11): 71-73.
[15] ZHANG Tong-xia1, YAN Chuan-zhu1, ZHAO Xiu-he1, CHI Ling-yi2. Clinical and neuroimaging features of patients with
middle cerebral artery stenosis [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2012, 50(11): 75-78.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
Copyright 2018 © Editorial office of Journal of Shandong University (Health Sciences)
Supported by Beijing Magtech Co.Ltd