Adult post‐infectious thalamic encephalitis: acute onset and benign course

Abstract

We report on two young patients with an encephalitic syndrome and bilateral thalamic lesions following a presumably viral or mycoplasma respiratory tract infection with the main clinical symptoms of organic psychosis in the first and a prolonged amnestic syndrome and ataxia in the second case. Four months later the patients had recovered clinically and the thalamic lesions had resolved on magnetic resonance imaging in one case and almost completely in the other. We interpret the patients' illness as rare cases of a post-infectious acute thalamic encephalitis in adults. The cases and their relationship to possible post-infectious autoimmune inflammatory or toxic pathophysiological mechanisms are discussed and a review of the literature is provided.

Acute Disseminated Encephalomyelitis with Bilateral Thalamic Necrosis

“…A similar benign course has been reported in young adults having bithalamic lesions. 4 In contrast, the patient reported here had severe residual deficits with persistent thalamic lesions.…”

Clinical Characteristics and MR Imaging Features of Nonalcoholic Wernicke Encephalopathy

“…A possible explanation for this divergence has been discussed in our previous report. 6 Apart from WE, the diseases with symmetric lesions of the bilateral medial thalami also include bilateral paramedian thalamic syndrome, 47 top-of-the-basilar syndrome (TOBS), 48 cerebral venous thrombosis, 49 viral encephalitis, 50 acute disseminated encephalomyelitis (ADEM), 30,51 and atypical Creutzfeldt-Jakob disease. 52 All these diseases can be differentiated from WE through clinical characteristics and MR imaging.…”