Kalita J, Misra U K, Srivastava A
Department of Neurology, Sanjay Gandhi PGIMS, Lucknow, India.
Electromyogr Clin Neurophysiol. 2009 Jan-Feb;49(1):27-33.
In view of paucity of studies on P3 in encephalitis, we report clinical, MRI and P3 changes in encephalitis patients.
The diagnosis of encephalitis was based on clinical, MRI, ELISA and/or PCR and categorized into Japanese encephalitis (JE), dengue, herpes (HSE) and nonspecific group. Cognitive functions were evaluated 1 month after the illness when patient was able to cooperate for Mini Mental State examination (MMSE). P3 was carried out by odd ball auditory paradigm recording from Cz, Fz and Pz referred to linked mastoids.
30 encephalitis patients including 16 JE, 2 HSE and 12 nonspecific whose median age was 24 (13-53) years were prospectively evaluated. P3 was studied after a median duration of 3 months. MMSE was abnormal in 19 patients. CzP3 was abnormal in 6; 5 of whom had abnormal MMSE. MRI was abnormal in 18 showing thalamic lesion in 13, basal ganglia in 3 and cortical in 7 patients. MMSE was abnormal in all the patients with HSE, 81% with JE and 33% with nonspecific encephalitis. P3 was more frequently abnormal in patients with abnormal MMSE and MRI.
Cognitive impairment is common in HSE and JE; abnormal MMSE and MRI are associated with P3 abnormality.
鉴于脑炎患者P3相关研究较少，我们报告脑炎患者的临床、MRI及P3变化情况。
脑炎诊断基于临床、MRI、ELISA和/或PCR，并分为日本脑炎（JE）、登革热、疱疹性脑炎（HSE）和非特异性组。在发病1个月后，当患者能够配合进行简易精神状态检查（MMSE）时，评估其认知功能。P3通过从连接乳突的Cz、Fz和Pz进行奇偶数听觉范式记录来完成。
前瞻性评估了30例脑炎患者，包括16例JE、2例HSE和12例非特异性脑炎患者，中位年龄为24岁（13 - 53岁）。在中位病程3个月后研究P3。19例患者MMSE异常。6例患者CzP3异常；其中5例MMSE异常。18例患者MRI异常，13例显示丘脑病变，3例显示基底节病变，7例显示皮质病变。所有HSE患者、81%的JE患者和33%的非特异性脑炎患者MMSE异常。MMSE和MRI异常的患者中P3更常出现异常。
认知障碍在HSE和JE中常见；MMSE和MRI异常与P3异常相关。
