Description

Rhomboencephalitis is encephalitis involving the brainstem. It may occur during viral or other infections. The severity can range from mild to life-threatening and can be graded based on the clinical findings.


Clinical Findings

Grade

generalized myoclonic jerks

tremor and/or ataxia

I

myoclonus

cranial nerve involvement

II

transient myoclonus

cardiorespiratory collapse

coma, loss of doll's eye reflex, apnea

III

 

Cranial nerve involvement may include one or both of the following:

(1) ocular disturbances: nystagmus, strabismus, gaze paresis

(2) bulbar palsy: dysphagia, dysarthria, dysphonia, facial weakness

 

Cardiopulmonary collapse includes:

(1) respiratory distress

(2) cyanosis

(3) fulminant pulmonary edema

(4) poor peripheral perfusion

(5) shock

 

MRI using T2-weighted scans may show high-intensity lesions in the brainstem.

 


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