Clinical features and management of two cases of encephalitis lethargica

  title={Clinical features and management of two cases of encephalitis lethargica},
  author={Stavia B. Blunt and Russell J. M. Lane and Nora Turjanski and G. D. Perkin},
  journal={Movement Disorders},
Two patients with presumed encephalitis lethargica are presented with clinical features suggestive of two forms of the disease described by Von Economo: One patient had a psychosis and a mute‐akinetic syndrome associated with myoclonus. The second patient presented with a psychosis and fever, developing severe dyskinesias involving the mouth, trunk and limbs, together with respiratory irregularities and presumed hypothalamic disturbance and disturbance of consciousness. In both cases, initial… 
Steroid-responsive encephalitis lethargica syndrome with malignant catatonia.
Intravenous methylprednisolone pulse therapy improved a 47-year-old man who is considered to have sporadic encephalitis lethargica (EL) and diagnosed secondary malignant catatonia due to EL syndrome, which may be secondary to autoimmunity against deep grey matter.
Contemporary Encephalitis Lethargica: Phenotype, laboratory findings and treatment outcomes
It is suggested that in addition to anti-BG Abs FDG PET should be considered as a diagnostic tool for EL, and laboratory/imaging tests may lead to early initiation of immunomodulating and supporting therapies.
Encephalitis lethargica in 5 South African children.
  • R. van Toorn, J. Schoeman
  • Medicine
    European journal of paediatric neurology : EJPN : official journal of the European Paediatric Neurology Society
  • 2009
The cases demonstrate that encephalitis lethargica does indeed occur among South African children and should be considered in any previously well child that presents with an acute encephalopathic illness with prominent extrapyramidal and neuropsychiatric symptoms and negative infectious, biochemical, autoimmune, metabolic and radiologic investigations.
Sporadic encephalitis lethargica
Three women (aged 21-36 years) developed acute illnesses that were similar to epidemic encephalitis lethargica. Each presented with a neuropsychiatric disturbance that was succeeded by pyrexia, a
Encephalitis lethargica like illness: case report and literature review.
Recent studies have revealed that encephalitis lethargica (EL) may not be related to influenza virus infection but more likely to be a post-infectious autoimmune disease. The diagnostic clinical
Contemporary encephalitis lethargica presenting with agitated catatonia, stereotypy, and dystonia‐parkinsonism
Two recent cases of EL characterized by an acute encephalitis with mixed movement disorders and psychiatric disorders support the hypothesis that this syndrome is an inflammatoryEncephalitis that specifically effects dopamine neurotransmission.
Encephalitis lethargica syndrome: 20 new cases and evidence of basal ganglia autoimmunity.
Investigation found no evidence of viral encephalitis or other recognized causes of rapid-onset parkinsonism, and investigated the possibility that this phenotype could be a postinfectious autoimmune CNS disorder, and therefore similar to Sydenham's chorea.
Encephalitis lethargica (von Economo's encephalitis).
This disorder differed from idiopathic Parkinson's disease by the presence of oculogyric crises, alterations in sleep cycle, respiratory disturbances, corticospinal tract findings, and its appearance in young persons.
Immune mediated chorea encephalopathy syndrome in childhood.
Four previously healthy female children, aged between 3 and 8 years, who presented with encephalopathy and an extrapyramidal movement disorder are reported, suggesting that these patients represent an immune-mediated movement disorder and encephalopathic syndrome.
Immune mediated chorea encephalopathy syndrome in childhood
We report four previously healthy female children, aged between 3 and 8 years, who presented with encephalopathy and an extrapyramidal movement disorder (chorea n=4, rigidity n=2, oculogyric crisis


Postencephalitic parkinsonism most often appeared in the second and third decade of life, and contemporary clinicians of the time were struck by the number of children and young adults affected.
Encephalitis lethargica. A report of four recent cases.
Electroencephalographic, evoked potential and autopsy data suggest that involvement of the cerebral cortex is more extensive than has been generally recognized and in keeping with a viral aetiology.
Encephalitis lethargica‐like illness in a girl with mycoplasma infection
MRI of the brain disclosed a striking pattern of subcortical involvement by the inflammatory process in a patient with mycoplasma infection and clinical manifestations of encephalitis lethargica, corroborating the clinical picture.
The present case report illustrates the development of an acute, very severe transient parkinsonian syndrome immediately following an infection with a coxsackie virus type B2.
Response of patients with postencephalitic Parkinsonism to levodopa 1
Patients with postencephalitic Parkinsonism may respond as well as patients with Parkinson's disease to levodopa but they develop both favourable responses and side-effects at a lower dosage and require careful dosage adjustments and close surveillance.
Post-encephalitic Parkinsonism: current experience
Eight recent patients are discussed, six of whom presented in the last 20 years, that conform to the diagnosis of encephalitis lethargica and the clinical features by which the diagnosis may be made are defined so that a contemporary definition of this disorder may be attained.
Movement disorders N. S. Shah andA. G. Donald (eds). Plenum Press, New York (1986). 406 pp. $49.50
This highly practical guide covers current approaches and new developments in the diagnosis, treatment, and management of movement disorders, including tremor, Parkinsonism, dystonia, chorea, tic,
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For almost a century hearing loss and ear disease in the patient with cleft palate have been subjects of extensive investigation. The first to report this association was Alt,1 who in 1878 noted
Encephalitis lethargica
The sequelae of encephalitis lethargica. Brain 1924;47:76-95
  • Movement Disorders,
  • 1997