Basal Ganglia Involvement in Pediatric Meningoencephalitis: Two Cases and a Literature Review.

BACKGROUND

is a common cause of respiratory tract infections in children, but neurological complications, including encephalitis, are increasingly recognized. Basal ganglia involvement is rare, and a poorly characterized feature of meningoencephalitis, with clinical consequences being inconclusive.

METHODS

We report two pediatric cases of -related meningoencephalitis with bilateral basal ganglia lesions seen on MRI. A literature review was conducted using PubMed, Scopus, and Web of Science to identify reports of -related meningoencephalitis in children, and related MRI findings.

RESULTS

Both patients (12-year-old male and 14-year-old female) presented with acute meningoencephalitis syndrome and had marked mononuclear pleocytosis. In both patients was confirmed with serological assay from serum sample, while in one patient was also confirmed by PCR from pharyngeal swab. Both exhibited bilateral basal ganglia lesions, with complete regression observed during follow-up. Treatment with corticosteroids led to full recovery in both cases. After a literature search, a total of 21 patients had basal ganglia involvement reported.

CONCLUSIONS

Literature suggests variable MRI findings in pediatric encephalitis, with basal ganglia involvement being uncommon and rarely reported, especially among older children. While diagnostic challenges related to extrapulmonary manifestations of the infection persist, basal ganglia involvement could aid in diagnosis, especially in older children presenting with meningoencephalitis along with pronounced pleocytosis when respiratory symptoms are absent or mild.