Misra U K, Kalita J, Jain S K, Mathur A
Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.
J Neurol Neurosurg Psychiatry. 1994 Dec;57(12):1484-7. doi: 10.1136/jnnp.57.12.1484.
Six patients with Japanese encephalitis, four males and two females whose age ranged between 2 and 47 years, were subjected to neurophysiological and radiological studies. An EEG in five of the patients showed diffuse delta wave activity and one had an alpha coma. Delta activity seems to be due to thalamic involvement, which was seen on CT of two and MRI of all the patients. The thalamic lesions were characteristically bilateral and were haemorragic in five. Changes on MRI included abnormalities of the brainstem in three and the basal ganglia and spinal cord in one patient each. Lower motor neuron signs were present in three patients but abnormal MRI signals in the spinal cord were present in only one out of three patients in whom spinal MRI was carried out. Central motor conduction time in the upper limb was prolonged in three patients (five sides) and in the lower limbs in one (both sides), which was consistent with involvement of the cerebral cortex, thalamus, brainstem, and spinal cord. Changes in MRI and EEG in the acute stage may provide early diagnostic clues in patients with Japanese encephalitis.
六名日本脑炎患者，四男两女，年龄在2岁至47岁之间，接受了神经生理学和放射学研究。五名患者的脑电图显示弥漫性δ波活动，一名患者呈α昏迷。δ活动似乎是由于丘脑受累，这在两名患者的CT和所有患者的MRI上均可见。丘脑病变的特征是双侧性，五例为出血性。MRI的变化包括三例脑干异常，一例基底节和脊髓异常。三名患者出现下运动神经元体征，但在进行脊髓MRI检查的三名患者中，只有一名患者脊髓MRI信号异常。三名患者（五个肢体）上肢的中枢运动传导时间延长，一名患者（双侧）下肢的中枢运动传导时间延长，这与大脑皮层、丘脑、脑干和脊髓受累一致。急性期MRI和脑电图的变化可能为日本脑炎患者提供早期诊断线索。
