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THE SUSPECTED CASE OF VIRUS ENCEPHALITIS WHICH MANIFESTED PROLONGED CEREBELLAR SYMPTOM Yuichiro GOTO 1 , Yoshio SAITO 1 , Kichinosuke SASAKI 1 1Dept. of Internal Medicine, Keio Univ. School of Medicine pp.417-422
Published Date 1964/5/1
DOI https://doi.org/10.11477/mf.1406201641
  • Abstract
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Authors believe that the most important diagnostic clue of encephalitis mainly depends on the basis of clinical symptom and signs, because causative agent of encephalitis is difficult to elucidate in some cases. We reported the case who developed diffuse cerebral dysfunction with acute onset and gradually localized in cerebellar signs which lasted for long period of time.

Case was 25 years old male patient who was admitted to our hospital with chief complaints of drowsiness, dizziness and ataxia. Patient was in good health until August 8, 1962 when he developed headache, dizziness and weakness in extremities. 5 days later he started to be drowsy and to have vomiting. There was no fever or seizure.

Neurological examination on admission revealed that patient was lethargy and responded to verbal stimuli very slowly with slurred speech and fluctuated state of consciousness. Cranial nerves and motor system seemed to be intact. No definite sensory impairment was found. Reflexes were hypoactive throughout without pathological reflex. Cerebrospinal fluid showed slight mononuclear pleocytosis with normal protein. Bacteriological study of cerebrospinal fluid failed to demonstrate any causative agent. Cerebral circulation study, carotid and vertebral arteriography, and electromyelography showed no abnormality. However EEG at onset showed diffuse cerebral dysfunction and marked improvement in following 2 records. Serum compliment fixation test of Japanese B encephalitis, polio I, II and III, Coxsackie B I, III, V., adeno V, influenza A, B, mumps and herpes simplex were all negative. After hospitalization confusional state of consciousness persisted for one month and gradually returned to normal condition. On the other hand, cerebellar signs such as ataxia, slurred speech, horizontal nystagmus, dysdiadochokinesis, Holmes-Stewart sign and cere-bellar titubation have developed. These lasted a few months and gradually improved, however, these signs are still remained in slight degree up to the present time. Pathogenesis of this disease was discussed and literatures were reviewed.


Copyright © 1964, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 2185-405X 印刷版ISSN 0006-8969 医学書院

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