37-year-old, Headache, Weakness in Legs

A 37-year-old patient presented with headache and muscle weakness in legs.

Figure 1A. FLAIR image shows bilateral basal ganglia hyperintensity, left temporal, and left parietal cortical/subcortical hyperintensity.

Figure 1B. FLAIR image shows bilateral basal ganglia hyperintensity, left temporal, and left parietal cortical/subcortical hyperintensity.

Figure 1C. FLAIR image shows bilateral basal ganglia hyperintensity, left temporal, and left parietal cortical/subcortical hyperintensity.

Figure 2: DWI imaging shows no evidence of restricted diffusion.

Figure 3. T1 contrast image shows no enhancement.

MRI was performed which showed bilateral basal ganglia hyperintensity and hyperintensity in cortical and subcortical region of left temporal and left parietal region on FLAIR images.

Bilateral thalamic involvement is classic regardless of CT or MR imaging.

Japanese encephalitis (JE) is one of many viral encephalitis and results from infection of the Japanese encephalitis virus.

JE is caused by the JE virus, a single-stranded RNA flavivirus.

Causes of T1 hyperintense basal ganglia lesions can also be considered. 

Radiologists may face a diagnostic challenge when CT/MRI findings of both JE and neurocysticercosis (NCC) are seen in the same patient.