alexa A Case of Suspicious Encephalitis Lethargica Accompanied by Visual Acuity Decrement
ISSN: 2329-6895

Journal of Neurological Disorders
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Case Report

A Case of Suspicious Encephalitis Lethargica Accompanied by Visual Acuity Decrement

Joon Hyun Baek and Kee Hyung Park*
Department of Neurology, Gil Medical Center, Gachon University, Incheon, Republic of Korea
Corresponding Author : Kee Hyung Park
Department of Neurology, Gil Medical Center
Gachon University, 1198 Guwoldong, Namdong-Gu
Incheon, 405-760 Republic of Korea
Tel: +82-32-460-3346
Fax: +82-32-460-3340
E-mail: [email protected]
Received August 04, 2014; Accepted August 10, 2014; Published August 13, 2014
Citation: Baek JH, Park KH (2014) A Case of Suspicious Encephalitis Lethargica Accompanied by Visual Acuity Decrement . J Neurol Disord 2:179. doi: 10.4172/2329-6895.1000179
Copyright: © 2014 Baek, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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Abstract

Encephalitis lethargica (EL) is a CNS disorder presenting with pharyngitis followed by sleep disorder, basal ganglia signs (particularly parkinsonism), and neuropsychiatric sequelae. It was first described in 1916, but only sporadic cases have been described since the 1916-1927. EL is a rare disease and difficult to confirm because no diagnostic criteria have been agreed. Its additional common features include oculogyric crises and ocular features (ophthalmoplegia and ptosis). However, no case of decreasing visual acuity has been previously reported. We report a case of EL with accompanying bilateral blindness. A 31-year-old female patient visited our emergency room complaining of a headache, fever, pharyngitis, and poor oral intake. After the fever and headache subsided, the patient experienced drowsiness and bilateral decreases in visual acuity. Brain magnetic resonance imaging (MRI) showed increased signal intensity on the hypothalamus on fluid attenuated inversion recovery (FLAIR) and T2 weighted images, which was compatible with EL. Although we critically discuss other potential etiologies, we conclude that her blindness constitutes an unusual presentation of EL.

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