RT Journal Article
SR Electronic
T1 Clinical and Radiological Features of Rotavirus Cerebellitis
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 1591
OP 1595
DO 10.3174/ajnr.A2131
VO 31
IS 9
A1 J. Takanashi
A1 T. Miyamoto
A1 N. Ando
A1 T. Kubota
A1 M. Oka
A1 Z. Kato
A1 S. Hamano
A1 S. Hirabayashi
A1 M. Kikuchi
A1 A.J. Barkovich
YR 2010
UL http://www.ajnr.org/content/31/9/1591.abstract
AB BACKGROUND AND PURPOSE: Neurological manifestations, such as benign convulsions and encephalitis/encephalopathy have been reported in patients with rotavirus gastroenteritis. However, cerebellitis has not attracted much attention. The purpose of this study was to identify and report the clinical and radiologic features of rotavirus cerebellitis. MATERIALS AND METHODS: Records of patients with rotavirus gastroenteritis exhibiting cerebellar lesions on MR imaging were collected from multiple centers in Japan. Their clinical, laboratory, and radiologic data were reviewed retrospectively. RESULTS: A diagnosis of acute cerebellitis concurrent with encephalitis was made for 11 of 13 patients identified. Two patients who were diagnosed as having injury due to hypovolemic shock were excluded from the study. All 11 patients with acute cerebellitis had disorders of consciousness with onset on days 2 to 4, followed by mutism in 10 patients. Other cerebellar symptoms included dysarthria following the mutism, hypotonia, ataxia, tremor, nystagmus, and dysmetria. MR imaging lesions in the vermis or cerebellar cortex were seen at some point (day 5 to 1 year) in 10 patients. A reversible splenial lesion (3 isolated and 3 with concurrent cerebellar lesions) was found in 6 patients scanned between days 4 and 6. Transient lesions in the cerebellar white matter/nuclei manifesting reduced diffusion were seen in 6 patients during days 5 through 7. The final MR imaging performed after 1 month showed cerebellar atrophy in 10 patients. CONCLUSIONS: The 11 patients with rotavirus cerebellitis exhibited nearly identical clinical and MR imaging features. Involvement of the cerebellar white matter/nuclei may be associated with the mutism. An isolated splenial lesion with homogeneously reduced diffusion is not always a benign sign indicative of complete clinical and radiologic recovery in patients with rotavirus gastroenteritis. AataxiaAESDacute encephalopathy with biphasic seizures and late reduced diffusionANEacute necrotizing encephalopathyCconsciousness disturbanceCCcorpus callosumCNScentral nervous systemDdayDydysarthriaEEGelectroencephalogramFLAIRfluid-attenuated inversion recoveryGgray matterHhypotoniaMeRmental retardationMERSclinically mild encephalitis/encephalopathy with a reversible splenial lesionMumutismNynystagmusNcerebellar nucleusPCRpolymerase chain reactionPtpatientSseizuresTtremorVvermisWwhite matter