Parkinsonism due to predominant involvement of substantia nigra in Japanese encephalitis

Pradhan, Sunil; Pandey, Nirmal; Shashank, S.; Gupta, Rakesh K.; Mathur, Asha

doi:10.1212/wnl.53.8.1781

Cited by 93 publications

(50 citation statements)

References 25 publications

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“…Almost one-half of patients from the 1917-1928 Spanish influenza pandemic developed 'encephalitis lethargica,' or parkinsonism with severe nigral cell loss, 15 often during the post-encephalitic phase and sometimes years later. Post-encephalitic parkinsonism (PEP) has been described after infection with non-WNV flaviviruses, including JEV, 16 and SLEV. 17,18 In fact, a group of investigators has used JEV to induce a Parkinson's disease model in rats, with the major resultant neuropathologic changes comprising neuronal loss and gliosis mainly confined to the substantia nigra pars compacta.…”

Section: Discussionmentioning

confidence: 99%

West Nile Virus Encephalomyelitis with Polio-like Paralysis & Nigral Degeneration

Schafernak

Bigio

2006

Can. j. neurol. sci.

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West Nile virus (WNV) is a mosquito-borne RNA virus in the genus Flavivirus (family Flaviviridae), and a member of the Japanese encephalitis serological group which comprises eight virus species including Japanese encephalitis virus (JEV) and St. Louis encephalitis virus (SLEV), and two subtype viruses. 1 Although most cases of WNV infection are subclinical or result in a mild, self-limited febrile illness known as West Nile fever, a minority of patients (<1%) develop acute neurologic disease, which can be severe and even fatal. 1-3 West Nile virus meningitis and encephalitis are often associated with favorable outcomes, 2 but when infection results in spinal anterior horn cell destruction it can cause an irreversible acute flaccid paralysis or poliomyelitis-like syndrome. [4][5][6][7][8][9][10][11] Movement disorders including parkinsonism, tremor and myoclonus have also been described. 2,[12][13][14] We present the clinical and neuropathologic findings in a ABSTRACT: Background: Patients infected with West Nile virus (WNV) may develop acute neurologic disease, which can be severe or even fatal, including WNV meningitis, encephalitis, and an irreversible acute flaccid paralysis or poliomyelitis-like syndrome. Movement disorders have also been described. Report: We report combined neuronal loss, gliosis, and neurofibrillary tangle formation in the substantia nigra of a 41-year-old man with a history of WNV encephalomyelitis and poliomyelitis-like paralysis. Conclusions: Clinically our patient did not display parkinsonism, however, it is interesting to speculate whether, in the absence of the residual subacute poliomyelitis-like syndrome, the neuropathologic findings could have eventually evolved clinically into WNV-associated postencephalitic parkinsonism. RÉSUMÉ: Encéphalomyélite due au virus du

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Section: Discussionmentioning

confidence: 99%

West Nile Virus Encephalomyelitis with Polio-like Paralysis & Nigral Degeneration

Schafernak

Bigio

2006

Can. j. neurol. sci.

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“…This epidemic gave rise to the belief that PD might be associated with an infectious agent such as a virus, especially Epstein Barr virus, influenza virus, coronavirus and Japanese encephalitis virus (7)(8)(9)(10)(11)(12). Since the 1980's, several additional microorganisms such as Borrelia burgdorferi, Haemophilus influenzae, Corynebacterium diphtheriae, Cryptococcus neoformans, Mycoplasma pneumoniae and Helicobacter pylori (13)(14)(15)(16) have been postulated as agents that could be associated etiologically with PD or another kind of parkinsonism.…”

Section: Introductionmentioning

confidence: 99%

Nocardia otitidiscaviarum (GAM-5) induces parkinsonian-like alterations in mouse

Díaz-Corrales

Colasante

Contreras

et al. 2004

Braz J Med Biol Res

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Parkinson's disease, a major neurodegenerative disorder in humans whose etiology is unknown, may be associated with some environmental factors. Nocardia otitidiscaviarum (GAM-5) isolated from a patient with an actinomycetoma produced signs similar to Parkinson's disease following iv injection into NMRI mice. NMRI mice were infected intravenously with a non-lethal dose of 5 x 10 6 colony forming units of N. otitidiscaviarum (GAM-5). Fourteen days after bacterial infection, most of the 60 mice injected exhibited parkinsonian features characterized by vertical head tremor, akinesia/bradykinesia, flexed posture and postural instability. There was a peak of nocardial growth in the brain during the first 24 h followed by a decrease, so that by 14 days nocardiae could no longer be cultured. At 24 h after infection, Gram staining showed nocardiae in neurons in the substantia nigra and occasionally in the brain parenchyma in the frontal and parietal cortex. At 21 days post-infection, tyrosine hydroxylase immunolabeling showed a 58% reduction of tyrosine hydroxylase in the substantia nigra, and a 35% reduction of tyrosine hydroxylase in the ventral tegmental region. Dopamine levels were reduced from 110 ± 32.5 to 58 ± 16.5 ng/mg protein (47.2% reduction) in brain from infected mice exhibiting impaired movements, whereas serotonin levels were unchanged (191 ± 44 protein in control and 175 ± 39 ng/mg protein in injected mice). At later times, intraneuronal inclusion bodies were observed in the substantia nigra. Our observations emphasize the need for further studies of the potential association between Parkinson's disease or parkinsonism-like disease and exposure to various nocardial species. Correspondence

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“…Myoclonus, parkinsonism, and opsoclonus have been described in other flavivirus infections, including WNV/NY99, MVEV, and JEV. 5,13,26 As with encephalitis from MVEV and JEV, CT imaging of the brain is insensitive for WNV/KUNV meningoencephalitis, which was shown by normal CT imaging in all six cases that underwent this test.…”

Section: Discussionmentioning

confidence: 98%

West Nile Virus (Kunjin Subtype) Disease in the Northern Territory of Australia—A Case of Encephalitis and Review of All Reported Cases

Gray¹,

Burrow²,

Markey³

et al. 2011

The American Society of Tropical Medicine and Hygiene

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West Nile virus Kunjin subtype (WNV/KUNV) is enzootic across the tropical north of Australia, with epizootic spread into other jurisdictions. The clinical spectrum of illness in humans is poorly described. We report a clinical case of WNV/KUNV encephalitis and performed a retrospective chart audit of all cases of WNV/KUNV notified in the Northern Territory from 1992 to 2010. Thirteen cases of WNV/KUNV disease were identified; case notes were available for 10 of these presentations. Six of these patients had confirmed infection and presented with neuroinvasive illness, whereas the other four suspect cases comprised three cases with arthralgia, myalgia, and/or rash and one case with fever alone. On the available evidence, WNV/KUNV is of lower virulence compared with the New York 1999 strain. Difficulties in serological diagnosis, especially when paired acute and convalescent sera are not available, may adversely impact the accuracy of the epidemiological and clinical understanding of this virus.

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Parkinsonism due to predominant involvement of substantia nigra in Japanese encephalitis

Cited by 93 publications

References 25 publications

West Nile Virus Encephalomyelitis with Polio-like Paralysis & Nigral Degeneration

West Nile Virus Encephalomyelitis with Polio-like Paralysis & Nigral Degeneration

Nocardia otitidiscaviarum (GAM-5) induces parkinsonian-like alterations in mouse

West Nile Virus (Kunjin Subtype) Disease in the Northern Territory of Australia—A Case of Encephalitis and Review of All Reported Cases

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