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Japanese encephalitis (JE) is an infectious encephalitis prevalent in Asia. It usually presents with fever, headache, convulsions and extrapyramidal symptoms. Limbic system involvement and hypothermia though common in autoimmune encephalitis have never been reported in JE. We report a case of an 18-year-old girl with no previous comorbidities who presented to us with a history of fever and headache for 1 week duration. She developed bilateral lateral rectus palsy and asymmetric flaccid weakness of all four limbs, after 2 days of admission, which was followed by altered sensorium and intermittent hypothermia. Neuroimaging revealed longitudinal myelitis extending from pons till the L1 level along with bilateral thalamic hemorrhage in brain. Cerebrospinal fluid (CSF) was positive for IgM antibody to JE virus. She was treated with supportive measures, but she developed intractable hypothermia and seizures and succumbed to illness after 2 weeks of admission.

Introduction: India is facing an increasing burden of diseases like coronary artery disease and stroke. Another peculiarity is that the number of cases of stroke in the young is more when compared to the west. There are also discrepancies among the different states of India regarding the epidemiological and clinical features of stroke. The aim of this study was to gather information regarding the clinical profile of patients admitted with ischemic stroke in a tertiary care centre in Thrissur, a district in the state of Kerala. Materials and Methods: The study included 100 consecutive patients admitted with the diagnosis of ischemic stroke, in the medicine wards of Government Medical College Thrissur. Patients above the age of 18 years and those cases in which the diagnosis was confirmed by CT scan of the brain were included in the study. Results: The majority of the patients were above 65 years of age (63%) and among the elderly 34 (54%) belonged to the age group of 65-74 years. In the age group above 65 years there were more females than males. The most common risk factor for stroke was hypertension. In the age group above 65 years, majority of the females had high LDL cholesterol values (>100 mg %) p 0.02 OR 4.7 95% CI 1.38-15.9. Conclusion: Elderly females have a greater predilection for the occurrence of stroke. Hypertension is the most common risk factor for stroke. Elevated LDL cholesterol is observed more often in elderly females. Earlier interventions aimed at the risk factors may prevent the occurrence of stroke.

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