Neuroimaging evaluation of pattern of brain involvement in Japanese encephalitis and other viral encephalitis in paediatric age group

Abstract

Introduction: Japanese encephalitis virus, a flavivirus is a significant cause of arboviral encephalitis worldwide. The virus is transmitted to humans via the bite of infected Culex mosquitoes especially C. tritaeniorhynchus , they prefer to bite outdoors and are extremely active and are extremely active in the evening and night. Neuroimaging reveals by MRI and CT scan of patients of Japanese encephalitis shows characteristic lesions particularly in the thalami, substantia nigra, basal ganglia, cerebral cortex, cerebellum, brainstem and white matter. Material and Method : A total of 50 patients divided in 25 anti JE antibody positive patients and another 25 in anti JE antibody negative group. A cross sectional observational analytical study was performed in the time period of January 2015 to August 2016, the patients was studied using IgM capture ELISA and 1.5T MRI machine. Result Analysis: The results were analysed using chi square test and p values. It was found that gray matter structures were the most commonly affected, the thalamus, basal ganglia but white matter lesions were also noted. The thalamus was the most commonly involved structure, followed by the brainstem and cerebral cortex. Haemorrhagic lesions were noted in the cortex, midbrain and cerebellum. Conclusion: Involvement of the thalamus showed the most significant difference between JE and non JE patients with 64% of the JE patients showed thalamic involvement. No other part of the brain showed such significant difference.