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Clinical and radiological predictors of outcome for Murray Valley encephalitis.

Authors
  • Speers, David J
  • Flexman, James
  • Blyth, Christopher C
  • Rooban, Nirooshan
  • Raby, Edward
  • Ramaseshan, Ganesh
  • Benson, Susan
  • Smith, David W
Type
Published Article
Journal
American Journal of Tropical Medicine and Hygiene
Publisher
American Society of Tropical Medicine and Hygiene
Publication Date
Mar 01, 2013
Volume
88
Issue
3
Pages
481–489
Identifiers
DOI: 10.4269/ajtmh.12-0379
PMID: 23296449
Source
Medline
License
Unknown

Abstract

A review of the laboratory-confirmed cases of Murray Valley encephalitis (MVE) from Western Australia between 2009 and 2011 was conducted to describe the clinical, laboratory, and radiological features of the disease. The nine encephalitis patients presented with altered mental state and seizures, tremor, weakness, or paralysis. All patients developed a raised C-reactive protein, whereas most developed acute liver injury, neutrophilia, and thrombocytosis. All patients with encephalitis developed cerebral peduncle involvement on early magnetic resonance imaging (MRI). The absence of thalamic MRI hyperintensity during the acute illness, with or without leptomeningeal enhancement, predicted a better neurological outcome, whereas those patients with widespread abnormalities involving the thalamus, midbrain, and cerebral cortex or the cerebellum had devastating neurological outcomes. MRI scans repeated months after acute illness showed destruction of the thalamus and basal ganglia, cortex, or cerebellum. These findings may help clinicians predict the neurological outcome when evaluating patients with MVE.

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