Encephalitis, viral symptoms

Case (i) Japanese viral encephalitis of a 28-year-old woman. Symptoms unconscious for 19 days, left-sided hemiplegia, constant convulsive motion on the right side of the body, loss of all superficial and deep reflexes. Prior to the onset of this disease, the patient was reported to have almost regular dreams of being murdered by a group of people. Then she developed headache, fever and unconscious state. 

Secondary parkinsonism Parkinsonian symptoms infrequently follow viral encephalitis or multiple small vascular lesions. Drugs such as the phenothiazines and haloperidol (see p. 127), whose major pharmacologic action is blockade of dopamine receptors in the brain, may also produce parkinsonian symptoms. These drugs should not be used in parkinsonian patients. 

The alphaviruses are a group of 26 icosahedral, positive-sense RNA viruses primarily transmitted by mosquitoes [64]. These 700-A-diameter viruses are some of the simplest of the membrane-enveloped viruses, and members of this group cause serious tropical diseases with characteristic symptoms such as myositis, fever, rash, encephalitis, and polyarthritis [65]. The structures of two different alphavirus-Fab complexes have been determined by cryo-TEM Ross River virus (RR) and Sindbis virus (SIN) [66]. The amino acid sequences of the RR and SIN virus structural and nonstructural proteins are 49 and 64% identical, respectively [67]. The viral RNA genome and 240 copies of the capsid protein form the nucleocapsid core [68-73], and the El and E2 glycoproteins form heterodimers that associate as 80 trimeric spikes on the viral surface. Native SIN and RR lack the E3 glycoprotein because it disassociates from the spike complex after its display on the plasma membrane surface [74, 75]. El has a putative fusion domain that may facilitate host membrane penetration [76, 77]. E2 contains most of the neutralizing epitopes and is also probably involved in host cell recognition [78-80]. 

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