MRI Patterns and Functional Outcomes in Patients with Viral Encephalitis

Abstract

Objective: To determine magnetic resonance imaging patterns in patients with viral encephalitis and assess their association
with functional outcomes at hospital discharge.
Material and Methods: This prospective observational study included 89 patients with viral encephalitis treated at Mardan
Medical Complex Mardan from 15 January 2023 to 15 September 2023. Clinical findings laboratory results and magnetic
resonance imaging characteristics were recorded. Functional outcome was assessed at discharge through the modified Rankin
Scale. Scores from 0 to 2 were classified as favorable while scores from 3 to 6 were classified as unfavorable. Associations
were assessed through chi square testing and multivariable logistic regression.
Results: Temporal limbic involvement was the most frequent magnetic resonance imaging pattern and was observed in 26
patients. Deep gray matter involvement was found in 18 patients while diffuse cortical involvement was present in 15 patients.
Diffusion restriction was identified in 54 patients and extensive involvement was found in 34 patients. Favorable outcome was
recorded in 51 patients while 38 patients had an unfavorable outcome. Extensive magnetic resonance imaging involvement was
independently associated with unfavorable outcome. A Glasgow Coma Scale score of 8 or below and brainstem involvement
were also significant predictors of poor recovery.
Conclusion
Magnetic resonance imaging patterns were associated with early functional outcome in viral encephalitis. Extensive involvement
and brainstem disease were linked with greater disability. Combined clinical and imaging assessment may support early
prognostic evaluation.
Keywords: Encephalitis Viral, Magnetic Resonance Imaging, Treatment Outcome, Prognosis, Seizures. Brain Diseases