以核磁共振早期診斷日本腦炎之病例報告

Case Report of Magnetic Resonance Imaging Findings Japanese Encephalitis

高崇智(Chung-Chih Kao) ； 李佳茹(Chia-Ru Li) ； 遲景上(Ching-Shiang Chi) ； 古劉愛敏(Ai-Min Ku Liu) ； 蔡青劭(Stella Chin-Shaw Tsai) ； 高佳慧(Chia-Hui Kao)

《童綜合醫學雜誌》 7卷2期 (2013/12) Pp. 76-79

摘要

在東亞洲及南亞洲，日本腦炎是一個最重要的病毒性腦炎。本院於2010年7月經歷一名1歲4個月大幼童，主訴咳嗽有痰及流鼻水，伴隨發燒已7天，5天內反覆全身僵直痙攣，意識不清，經腦部MRI檢查與日本腦炎之IgM抗體效價四倍增加診斷為日本腦炎。日本腦炎的診斷包括季節性、居住地區、流行地區工作或旅遊史、蚊蟲叮咬、疫苗接種、臨床表徵、血清學檢查與腦部MRI檢查等。多篇文獻指 出典型之腦部MRI特徵有助於早期診斷，因此當病患出現發燒、頭痛、意識不清，且腦部MRI出現特徵性丘腦病變，須高度懷疑為日本腦炎。而接種日本腦炎疫苗是最直接有效的預防方法。

關鍵字

日本腦炎 ； 核磁共振影像 ； 日本腦炎抗體

並列摘要

Japanese encephalitis is an important cause of viral encephalitis in East and South Asia. Here we report the case of a 16-month-old boypresenting with a 7-day history of cough and runny nose, accompanied by fever. On clinical presentation, he developed repetitive general spasms and unconsciousness. A 4-fold increase was detected in serum immunoglobulin M antibody titers for Japanese encephalitis virus. Diagnosis of Japanese encephalitis was confirmed on the basis of several factors: seasonality, location, work or travel within endemic areas, mosquito bites, vaccination history, clinical features, serology, and brain magnetic resonance imaging (MRI). These findings suggest that when a patient with suspected Japanese encephalitis develops fever, headache, and a change in consciousness, typical hypothalamic lesions identified on brain MRI can clarify the diagnosis. Currently, Japanese encephalitis vaccination is the most direct and effective method of preventing this disease.

並列關鍵字

Japanese encephalitis ； MRI