Serial Magnetic Resonance Imaging and Single Photon Emission Computed Tomography Study of Acute Disseminated Encephalomyelitis Patient after Japanese Encephalitis Vaccination

Abstract

Summary:We report a 5-year-old mentally retarded Japanese boy who developed acute disseminated encephalomyelitis (ADEM) two weeks after Japanese encephalitis vaccination (Beijing strain). He presented sudden status epilepticus, fever, and disturbance of consciousness. Initial neuroradiological findings revealed multifocal cortical swellings without any white matter lesions, suggesting the existence of partial encephalitis or focal status epilepticus. On the follow-up neuroradiological examinations, small white matter lesions were identified as having gradually extended in spite of clinical improvement by methylprednisolone pulse therapy. The cortical involvement became temporarily worse along with the extension and delayed appearance of white matter lesions. Single photon emission computed tomography (SPECT) showed marked hypoperfusion of cerebral blood flow (CBF) in the cortical lesions at both the acute and the recovery period. The serial neuroradiological findings indicated involvement of white matter and gray matter regions at different stages of the illness and a delay between the onset of symptoms and the appearance of ADEM-associated MR imaging of white-matter lesions.

Japanese Encephalitis Virus-Induced Anti-N-Methyl-D-Aspartate Receptor Encephalitis: A Case Report and Review of Literature

“…The following mechanisms of virus-associated autoimmune neuroinflammation have been postulated. (1) Some microbial proteins induced by vaccination might cause autoimmune diseases because components of these proteins are similar to human proteins, 6 the patient with postvaccination anti-NMDARe identified in our review may further confirm this speculation; (2) JE vaccines have been reported to be linked to acute disseminated encephalomyelitis 15 ; therefore there is a chance that JEV may induce anit-NMDARe; (3) antigens released by viral neuronal lysis and inflammation have been hypothesized to lead to synaptic autoimmunity have been speculated, positive findings in the CSF but negative findings in the serum for anti-NMDAR were observed in half of the patients reviewed in our study. 7 Thus, the observation in favor of the hypothesis of neuronal destruction resulting from NMDAR exposure to central nervous system immunity which further leads to the development of anti-NMDAR.…”

Anti-NMDA Receptor Encephalitis and Vaccination

“…Two children developed acute disseminated encephalomyelitis (ADEM) after Japanese B encephalitis vaccination [ 33 ]. A five-year-old Japanese boy also developed ADEM two weeks after JE vaccination [ 34 ].…”

Cortical Oligodendrocytes in Kaolin-Induced Hydrocephalus in Wistar Rat: Impact of Degree and Duration of Ventriculomegaly

“…Cytokines such as platelet derived growth factor, fibroblast growth factor and hepatocyte growth factor, and chemotrophic factors such as netrins and the chemokine CXCL1 affect migration [3][4][5][6][7] . Notably, some OPCs persist while majority differentiate into myelin producing oligodendrocytes [8] .…”