AN AUTOPSIED CASE OF ACUTE LYMPHOCYTIC MENINGOENCEPHALITIS WITH A LONG CLINICAL COURSE - SPECIAL REFERENCE TO CT, MR, SPECT AND NEUROPATHOLOGICAL FINDINGS

This report describes the clinico-pathological features of acute lymph ocytic meningoencephalitis (ALME) of a patient with a long clinical co urse of 24 months. The patient rapidly developed a confusional state, occasionally with stupor, various involuntary movements and generalize d convulsions followed by fever and headache at the age of 29. Clinica l symptoms, except fever and convulsions, had not distinctly improved throughout the clinical course, and cortical atrophy on CT and MR grad ually progressed. SPECT revealed a low blood perfusion in the cerebral cortices. Neuropathologically, inflammatory findings were very mild, but nerve cells degenerated prominently. From these clinicopathologica l findings, it is suggested that chronic degenerative changes followed an acute inflammatory phase.