Chronic Herpes Simplex Encephalitis with Somnambulism: CT, MR and SPECT Findings

Hori, Takafumi; Suzuki, Tomohiko; Terashima, Yasushi; Kawai, Nobuyoshi; Shiraishi, Hiroyasu; Koizumi, Junzo

doi:10.1111/j.1440-1819.1990.tb01652.x

Cited by 8 publications

(10 citation statements)

References 9 publications

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“…Diffusion-weighted imaging is more sensitive than T2-weighted imaging for the detection of abnormalities in herpes simplex encephalitis; however, if the lesion is unilateral, the diffusion-weighted imaging findings may be confused with those of Creutzfeldt-Jakob disease. The affected regions in herpes simplex encephalitis show necrotic or hemorrhagic parenchymal swelling in the early stage (Fig 9), a feature that is never observed in Creutzfeldt-Jakob disease (43)(44)(45)(46)(47).…”

Section: Chronic Herpes Encephalitismentioning

confidence: 99%

Diffusion-weighted MR Imaging of Early-Stage Creutzfeldt-Jakob Disease: Typical and Atypical Manifestations

Ukisu¹,

Kushihashi²,

Tanaka³

et al. 2006

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Creutzfeldt-Jakob disease causes progressive dementia and, eventually, death. The infectious agent is thought to be proteinaceous scrapie particles. Prompt diagnosis is essential to prevent human-to-human transmission. Progressive brain atrophy and areas of high signal intensity in the cerebral cortex and basal ganglia are well-known features of Creutzfeldt-Jakob disease depicted on T2-weighted magnetic resonance (MR) images. However, in the early stage of disease, the appearance of the brain on T2-weighted MR images often is normal, and it may be impossible on that basis to reach a diagnosis. Diffusion-weighted imaging therefore has gained attention as a useful modality for the early diagnosis of Creutzfeldt-Jakob disease. Even before the appearance of the characteristic periodic synchronous discharges on the electroencephalogram, diffusion-weighted images in most cases of Creutzfeldt-Jakob disease depict areas of abnormal signal hyperintensity in the cortex and in the basal ganglia or thalamus. These imaging abnormalities are accompanied by decreased apparent diffusion coefficient values suggestive of restricted diffusion within the tissue. However, if diffusion-weighted imaging findings of abnormal high signal intensity are restricted to the cerebral cortex, it may be necessary to differentiate between Creutzfeldt-Jakob disease and other conditions that may produce progressive dementia (eg, venous hypertensive en-cephalopathy; chronic herpes encephalitis; and the syndrome of mitochondrial myopathy, encephalopathy, lactic acidosis, and strokelike episodes).

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Section: Chronic Herpes Encephalitismentioning

confidence: 99%

Diffusion-weighted MR Imaging of Early-Stage Creutzfeldt-Jakob Disease: Typical and Atypical Manifestations

Ukisu¹,

Kushihashi²,

Tanaka³

et al. 2006

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“…Patients with focal necrotizing temporal lobe lesions mimicking brain tumors that require diagnostic and therapeutic lesionectomy have also been described (25). At the other extreme, chronic herpes encephalitis with somnambulism and memory disturbance for 9 months has been reported (44). Although most cases of HSV-1 encephalitis in immunocompetent hosts remain the classic, necrotizing frontal-temporal distribution type with significant neurologic deficit, a broader clinical and radiographic spectrum of HSV encephalitis exists than was formerly realized.…”

Section: Hsv-1mentioning

confidence: 99%

The Expanding Spectrum of Herpesvirus Infections of the Nervous System

Kleinschmidt-DeMasters¹,

2001

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Herpesviruses cause various acute, subacute, and chronic disorders of the central (CNS) and peripheral (PNS) nervous systems in adults and children. Both immunocompetent and immunocompromised individuals may be affected. Zoster (shingles), a result of reactivation of varicella zoster virus (VZV), is the most frequent neurologic complication. Other neurological complications include encephalitis produced by type I herpes simplex virus (HSV-1), and less frequently HSV-2, as well as by VZV and cytomegalovirus (CMV). Acute meningitis is seen with VZV and HSV-2, and benign recurrent meningitis with HSV-2. Combinations of meningitis/ encephalitis and myelitis/radiculitis are associated with Epstein Barr Virus (EBV); myelitis with VZV, CMV, EBV, and HSV-2; and ventriculitis/encephalitis with VZV and CMV. Brainstem encephalitis due to HSV and VZV, and polymyeloradiculitis due to CMV are well documented. HHV-6 produces childhood exanthem subitum (roseola) and febrile convulsions. Immunocompetent and immunocompromised hosts manifest different incidences and patterns of herpesvirus infections. For example, stroke due to VZV-mediated large vessel disease (herpes zoster ophthalmicus) occurs predominantly in immunocompetent hosts, while small vessel disease (leukoencephalitis) and ventriculitis develop almost exclusively in immunocompromised patients. EBV-associated primary CNS lymphomas also are restricted to immunosuppressed individuals. Recent large CSF PCR studies have shown that VZV, EBV, and CMV more frequently produce meningitis, encephalitis, or encephalopathy in immunocompetent hosts than was formerly realized. We review herpesvirus infections of the nervous system and illustrate the expanding spectrum of disease by including examples of a 75-year-old male on steroid treatment for chronic lung disease with fatal HSV-2 meningitis and an 81-year-old male with myasthenia gravis, long-term azathioprine use, and an EBV-associated primary CNS lymphoma.

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“…In contrast to our patient, literature review showed that most cases of chronic HSE-1 had a documented acute central nervous system infection [1][2][3][4][5][6][7] up to 13.5 years prior [6]. Few reports of chronic HSE without prior acute infection include an infant with undefined perinatal infection [1] and a patient with asymptomatic HSV-2 infection [11]. Other cases suspicious of chronic HSE lacked etiologic confirmation by CSF PCR or histology [12,13].…”

Section: Resultsmentioning

confidence: 49%

Chronic herpes simplex type-1 encephalitis with intractable epilepsy in an immunosuppressed patient

et al. 2015

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Chronic Herpes Simplex Encephalitis with Somnambulism: CT, MR and SPECT Findings

Cited by 8 publications

References 9 publications

Diffusion-weighted MR Imaging of Early-Stage Creutzfeldt-Jakob Disease: Typical and Atypical Manifestations

Diffusion-weighted MR Imaging of Early-Stage Creutzfeldt-Jakob Disease: Typical and Atypical Manifestations

The Expanding Spectrum of Herpesvirus Infections of the Nervous System

Chronic herpes simplex type-1 encephalitis with intractable epilepsy in an immunosuppressed patient

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