An Adult Case of Mumps Brainstem Encephalitis.

Abstract

Wepresent an adult case of mumps brainstem encephalitis. He was successfully treated with steroid pulse therapy and recovered completely except for persistent dysuria. He had not been vaccinated and had no history of acute mumps infection. Weconsider that encephalitis in this case was caused by a reversible autoimmuneprocess triggered by mumps infection. Weemphasize the usefulness of pulse therapy for the treatment of somecases of mumps brainstem encephalitis in addition to the importance of mumpsvaccination to prevent such a severe complication as encephalitis.

Magnetic Resonance Imaging Findings of Mumps Meningoencephalitis with Bilateral Hippocampal Lesions without Preceding Acute Parotitis: A Case Report

“…Two pathological mechanisms have been proposed for mumps encephalitis ( 2 6 ). The first, primary mumps meningoencephalitis, involves direct invasion of the CNS by the virus and is associated with the appearance of encephalitis during the early disease stage.…”

“…Focal CNS involvement is less common in mumps than is meningitis. In the English literature, mumps encephalitis affects the brainstem, basal ganglia, splenium of the corpus callosum, and white matter, and it is considered a form of ADEM ( 1 2 3 4 5 6 7 8 9 10 ); however, bilateral hippocampal lesions resulting from mumps viral infection have not been previously reported. Other pathogens that should be included in the differential diagnosis of bilateral hippocampal lesions include herpes simplex virus, Ebstein-Barr virus, and Cytomegalovirus .…”

“…Focal cerebral edema secondary to persistent temporal lobe seizures might be considered imaging findings in our case, but clinical course and serological evidence of apparent mumps infection strongly suggested that the patient's condition resulted from the mumps. Notably, no established effective therapy is available for mumps encephalitis ( 2 ), although vaccination provides useful prophylaxis ( 2 ). We could not establish a vaccination history for our patient.…”

“…The virus usually causes parotitis but sometimes results in central nervous system (CNS) complications such as acute aseptic meningitis or acute or chronic encephalitis. CNS involvement has been reported to occur in up to 65% of cases of mumps ( 1 2 ), and meningitis accounts for a major proportion of CNS complications ( 1 ). The development of encephalitis is rare ( 3 ), with a reported incidence of 1 per 6000 mumps cases.…”

“…The development of encephalitis is rare ( 3 ), with a reported incidence of 1 per 6000 mumps cases. However, encephalitis has a much graver prognosis 382than meningitis ( 1 2 ), with mortality rates ranging from 2.3% to 22% and long-term morbidity ranges of from 24% to 33% ( 1 ). Here, we describe an adult case of acute mumps meningoencephalitis that manifested as seizure and impaired consciousness with neuroimaging findings of bilateral hippocampal encephalitis and meningitis.…”