cqvip:A case of tick borne encephalitis (TBE) is reported, with simultaneous brain stem, spinal cord, and bilateral thalamic involvement confirmed by magnetic reso nance imaging (MRI). After exposure to a TBE endemic region, the patient develop ed a biphasic clinical course with initial flu-like symptoms followed by a sev ere brain stem syndrome. The diagnosis of TBE was confirmed sirologically. Repea ted MRI scans showed brain stem, bithalamic, and spinal cord involvement. The ou tcome was favourable. TBE cases with concomitant myelitis tend to have a more se vere clinical course and more likelihood of needing intensive care support. They should therefore be identified early in order to be prepared for life threateni ng respiratory complications.
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