High echoes in both thalami have been reported only in asphyxiated neonates. We describe high echoes in both thalami in an infant with Japanese encephalitis.
The patient was a 3-month old male infant. He had a high fever for 4 days and episodes of convulsions. On admission, his face was disinterested and he was stuporous. Few active movements were recognized. The anterior fontanel was tense. Neck stiffness and Kernig's sign were recognized. In the cerebrospinal fluid the white blood cells and protein were increased. The glucose was normal. After checking in to the hospitol, his general condition became better. On the 3rd day, the fever decreased and he could nurse. On the 5th day, his level of consciousness became normal. He was diagnosed as having Japanese encephalitis as indicated by an increase in the viral antibody titer. Serial brain ultrasonographic studies revealed high echoic lesions in both thalami in the acute phase, and calcification with acoustic shadows in the chronic phase. These findings were compatible with the ptahological findings in Japanese encephalitis.
