NEURAL INVOLVEMENT IN KAWASAKI DISEASE

Abstract

Neurological findings and histopathology of the nervous system were studied in 30 patients with Kawasaki disease. As neurological manifestations, irritability, lethargy, meningeal signs such as nuchal rigidity, Kernig''s sign, opisthotonus and facial nerve paralysis were present. In 9 of 11 patients whose CSF was examined, pleocytosis, consisting mainly of lymphocytes and mononuclear cells, was seen. Protein and glucose concentrations were within the normal range. On histopathological investigation, aseptic choriomeningitis and/or leptomeningitis were present in 7 of 14 patients. Severe edema, edema necrosis and localized status spongiosus were frequently observed. Atrophy, nonspecific degeneration and loss of neurons were detected; pathognomonic changes were not evident. Marginal gliosis in the subpendimal region and superficial cerebral cortex and glial nodule formation surrounding the degenerated neurons were occasionally seen. Vascular changes such as endoarteritis, periarteritis and perivascular cuffing were present in 5 of 14 patients, though such lesions were geneally mild. Ganglionitis and neuritis in the various areas were seen in 13 patients.