Kubota Tetsuo, Suzuki Toshihiko, Kitase Yuma, Kidokoro Hiroyuki, Miyajima Yuji, Ogawa Akimasa, Natsume Jun, Okumura Akihisa
Department of Pediatrics, Anjo Kosei Hospital, Anjo-cho, Aichi, Japan.
Brain Dev. 2011 Jan;33(1):21-7. doi: 10.1016/j.braindev.2010.04.007. Epub 2010 May 26.
Rotavirus is one of the most common causes of gastroenteritis in children and is known to accompany some neurological disorders such as encephalitis/encephalopathy and seizures. Although cerebellar disorders sometime occur as a complication of rotavirus gastroenteritis in Japan, few reports have addressed these issues. Here, we report three cases of insulted cerebellums in addition to encephalitis/encephalopathy associated with rotavirus. Similar to posterior fossa syndrome after surgery, mutism was a notable symptom that lasted about 1 month. Brain diffusion-weighted imaging (DWI) revealed chronological changes, i.e., marked hyperintensity in the bilateral dentate nucleus followed by the vermis and cerebellar hemisphere. The bilateral dentate nucleus is known to be a key lesion site for mutism, and these clinical and radiological findings may be tightly connected in rotavirus-associated cerebellitis/cerebellopathy.
轮状病毒是儿童肠胃炎最常见的病因之一,已知其会伴随一些神经系统疾病,如脑炎/脑病和癫痫发作。虽然在日本,小脑疾病有时会作为轮状病毒肠胃炎的并发症出现,但很少有报告涉及这些问题。在此,我们报告3例除了与轮状病毒相关的脑炎/脑病之外还伴有小脑损伤的病例。与手术后的后颅窝综合征相似,缄默是一个持续约1个月的显著症状。脑扩散加权成像(DWI)显示了按时间顺序的变化,即双侧齿状核先出现明显高信号,随后是蚓部和小脑半球。已知双侧齿状核是缄默的关键病变部位,这些临床和影像学发现可能在轮状病毒相关的小脑炎/小脑病变中紧密相关。