Extra temporal involvement in herpes simplex encephalitis

Wasay, Muhammad; Mekan, Sabeen; Khelaeni, Bhojo; Saeed, Zeb; Hassan, Amman; Cheema, Zahid; Bakshi, Rohit

doi:10.1111/j.1468-1331.2005.00999.x

Cited by 68 publications

(48 citation statements)

References 21 publications

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“…In the study conducted by Panisset et al, unilateral thalamic involvement was observed in 50% of the cases (18). Our results confirmed that the range of neuroradiological features varies in children as it has been described in previous studies and the proportion of extratemporal lesions is higher than it is in adults (3,12,19).…”

Section: Wwwjtomcorgsupporting

confidence: 81%

Clinical Spectrum of the Herpes Simplex Encephalitis in Children: Clinical Features, Neuroimaging, Treatment, and Outcomes

2015

J Turgut Ozal Med Cent

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Objective: Herpes simplex encephalitis is one of the most common causes of sporadic encephalitis in children and it is associated with high mortality and morbidity. This study aims at describing the clinical spectrum of herpes simplex encephalitis in children by identifying their neurological imaging features and assessing potential treatment outcomes. Methods: Clinical, laboratory, and imaging findings in 14 patients with herpes simplex encephalitis were retrospectively reviewed during the period between January 2005 and January 2010 at Selcuk University, Department of Pediatric Neurology. Results: Our study consisted of 14 patients including a patient who had a relapsing course. The median age of the patients was 3,6 years. Seizure and fever were the most common findings at admission. Cerebrospinal fluid glucose concentration was normal in all patients. Protein and red blood cell levels were elevated in 28% patients. Polymerase chain reaction testing for HSV was positive in 92% and cranial magnetic resonance imaging was suggestive of herpes simplex encaphalitis in all the patients. Prominent thalamic involvement was observed in patients less than 2 years of age, however cerebrospinal fluid findings in these patients were normal. 9 patients were left with no neurological sequelae however persistent neurological sequelae was present in 5 patients. Conclusion: The findings suggested how challenging it could get to diagnose herpes encephalitis in children, especially those under the age of 2. Due to its diagnostic possibility in children presenting with convulsion and other encephalitic processes, treatment with acyclovir must be initiated as soon as herpes encephalitis is suspected to avoid further neurological insults. Key Words: Herpes Encephalitis; Children; Acyclovir; Neuroimaging.Çocuklarda Herpes Simpleks Ensefalitinin Klinik Spektrumu: Klinik Bulgular, Nörogörüntüleme, Tedavi ve Sonuçlarının Değerlendirilmesi Özet Amaç: Herpes simpleks ensefaliti çocuklarda sporadik ensefalitlerin en sık görülen nedenlerinden biridir ve yüksek morbidite ve mortalite oranına sahiptir. Bu çalışmada çocuklarda klinik ve nörogörüntüleme bulgularıyla tedavi sonuçlarının değerlendirilerek herpes simpleks ensefalitinin klinik spektrumunun belirlenmesi amaçlanmıştır. Gereç ve Yöntem: Selçuk Üniversitesi, Çocuk Nöroloji kliniğinde 2005-2010 yılları arasında herpes simpleks ensefaliti tanısı ile izlenen 14 hastanın klinik, laboratuvar ve görüntüleme bulguları geriye yönelik olarak değerlendirildi. Bulgular: Serimiz rekürrens gösteren 1 olgu da dahil olmak üzere 14 hastadan oluşuyordu. Olgularımızın ortalama yaşı 3,6 yıl, en sık başvuru şikayetleri ise nöbet ve ateşti. Beyin omurilik sıvısı glukoz konsantrasyonu olguların tümünde normal bulunurken yüksek protein ve eritrosit değerleri olguların %28'inde tespit edildi. Herpes simpleks virüs polimeraz zincir reaksiyonu olguların %92'sinde pozitifti ve kraniyal manyetik rezonans görüntüleme bulguları olguların tümünde herpes simpleks ensefalitini düşündürmekteydi. 2 yaş altındak...

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Section: Wwwjtomcorgsupporting

confidence: 81%

Clinical Spectrum of the Herpes Simplex Encephalitis in Children: Clinical Features, Neuroimaging, Treatment, and Outcomes

2015

J Turgut Ozal Med Cent

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“…The authors concluded that ictal piloerection is predominately seen in patients with temporal lobe seizure foci and does not appear to correlate with laterality [1]. This finding dovetails with the characteristic pattern of temporal and insular lobe edema seen on MRI in patients with HSV encephalitis [2]. The associated focal piloerection seen in our patient is likely attributable to neuronal hyperexcitation of his left or right mesial temporal lobe given the MRI findings.…”

supporting

confidence: 62%

A hair-raising diagnosis: goose bumps as sign of herpes simplex encephalitis

Brazg¹,

Gillett²

2015

The American Journal of Emergency Medicine

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“…HSV has the ability to enter the central nervous system (CNS), and replicate in neurons and glia cells. The inflammatory process of HSE is characterized by hemorrhagic-necrotizing features and localized in the predilection sites within the fronto-temporal brain regions, albeit extratemporal manifestations can be observed on occasion [60,101].…”

Section: Pathogenesis Of Hsementioning

confidence: 99%

Seizures and epilepsy in herpes simplex virus encephalitis: current concepts and future directions of pathogenesis and management

Sellner

Trinka

2012

J Neurol

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Mortality related to herpes simplex virus encephalitis (HSE) dropped dramatically with the systematic initiation of antiviral treatment in encephalitic syndromes. Further efforts need to be taken to reduce long-term morbidity in the survivors. In this regard, the high rate of postencephalitic epilepsy, which is frequently refractory to medical treatment, contributes significantly to the unfavorable clinical outcome of the disease. Seizures during the acute phase of HSE are the main risk for the development of postencephalitic epilepsy. Yet, there are no randomized controlled trials for the management of acute seizures, preventive measures or the ideal duration of antiepileptic treatment. Hence, concepts for the medical treatment of seizures during the acute phase of HSE and postencephalitic epilepsy are eagerly awaited. Epilepsy surgery is a potential treatment option for the latter, but only promising in a subgroup of patients suffering from unilateral mesio-temporal lobe epilepsy and congruent neuropsychological impairment. Relapsing HSE and post-infectious autoimmune conditions can lead to seizures in the aftermath of acute HSE. These conditions need to be kept in mind in order to promptly assure the initiation of accurate diagnostic steps and respective treatment. The purpose of this review is to summarize the current pathogenetical understanding, clinical and diagnostic considerations, and treatment options of seizures in acute HSE and postencephalitic epilepsy.

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Extra temporal involvement in herpes simplex encephalitis

Cited by 68 publications

References 21 publications

Clinical Spectrum of the Herpes Simplex Encephalitis in Children: Clinical Features, Neuroimaging, Treatment, and Outcomes

Clinical Spectrum of the Herpes Simplex Encephalitis in Children: Clinical Features, Neuroimaging, Treatment, and Outcomes

A hair-raising diagnosis: goose bumps as sign of herpes simplex encephalitis

Seizures and epilepsy in herpes simplex virus encephalitis: current concepts and future directions of pathogenesis and management

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