Synonyms:
Encephalitis lethargica a.k.a. postencephalitic parkinsonism a.k.a. Von Economo encephalitis:
Diagnosis:
Clinical:
- Prodrome: pharyngitis
- Subacute sleep disturbance (hypersomnolence, reversal of diurnal sleep pattern or insomnia), ophthalmoparesis, lethargy
- Followed by: Parkinsonism, dyskinesia, oculogyric crisis, neuropsychiatric symptoms and central respiratory abnormalities
Pathology:
- Midbrain and basal ganglia: lymphocyte (predominantly plasma cell) infiltration
Investigations to consider:
CSF:
- Oligoclonal bands
- Protein: Elevated
MRI:
- FLAIR hyperintensity: Midbrain & periaqueductal grey. Also in Thalamus & putamen
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