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J Neurol Neurosurg Psychiatry 2005;76:135-137 doi:10.1136/jnnp.2004.040469
  • Short report

Severe tick borne encephalitis with simultaneous brain stem, bithalamic, and spinal cord involvement documented by MRI

  1. A Bender1,
  2. G Schulte-Altedorneburg2,
  3. E U Walther1,
  4. H-W Pfister1
  1. 1Department of Neurology, University of Munich, Klinikum Grosshadern, Munich, Germany
  2. 2Department of Neuroradiology, University of Munich
  1. Correspondence to:
 Dr Andreas Bender
 Department of Neurology, University of Munich, Klinikum Grosshadern, Marchioninistr 15, 81377 Munich, Germany; andreas.bendermed.uni-muenchen.de
  • Received 2 March 2004
  • Accepted 16 April 2004
  • Revised 16 April 2004

Abstract

A case of tick borne encephalitis (TBE) is reported, with simultaneous brain stem, spinal cord, and bilateral thalamic involvement confirmed by magnetic resonance imaging (MRI). After exposure to a TBE endemic region, the patient developed a biphasic clinical course with initial flu-like symptoms followed by a severe brain stem syndrome. The diagnosis of TBE was confirmed serologically. Repeated MRI scans showed brain stem, bithalamic, and spinal cord involvement. The outcome was favourable. TBE cases with concomitant myelitis tend to have a more severe clinical course and more likelihood of needing intensive care support. They should therefore be identified early in order to be prepared for life threatening respiratory complications.

Footnotes

  • Competing interests: none declared

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