Psychosis and Herpes Simplex Encephalitis

Schlitt, Michael; Lakeman, Fred D.; Whitley, Richard

doi:10.1097/00007611-198511000-00021

Cited by 38 publications

(13 citation statements)

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“…Examination of the cerebrospinal fluid revealed mild pleocytosis or normal findings (4, 5). In some patients the EEG and cerebral computer tomography also appeared normal (4), while in others temporal-mainly unilateral-abnormalities were seen (3,4).…”

Section: Discussionmentioning

confidence: 99%

Acute Confusion—an Unusual Form of Cerebral Herpes Simplex Virus Infection?

Norman

Lundberg²,

Forsgren³

et al. 1991

Acta Paediatrica

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Herpes simplex virus (HSV) infections are common and, if afflicting the central nervous system, may cause death or severe sequelae. Since specific therapy is now available there is an increasing demand for the recognition of the various ways in which cerebral HSV-infections may be manifested. This report describes a 15-year-old boy who presented acutely with mental symptoms of confusion, hallucinations and sleep disturbance. Simultaneously, but without any increase in cerebrospinal fluid cell or protein content, an intrathecal production of HSV-antibodies of transient nature was detected. These findings suggest that the patient may have suffered from an unusual form of herpes infection in the central nervous system. We suggest that similar cases should be thoroughly explored for possible herpes etiology as early as possible during the acute phase of the disease.

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Section: Discussionmentioning

confidence: 99%

Acute Confusion—an Unusual Form of Cerebral Herpes Simplex Virus Infection?

Norman

Lundberg²,

Forsgren³

et al. 1991

Acta Paediatrica

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“…One typical example of schizophrenia induced by transmission is the syndrome of herpes encephalitis. The syndrome is very rare, affl icting approximately 1 per 200,000 cases per year, but the diagnosis and therapy are very well described (Schlitt et al 1985 ;Whitley and Lakeman 1995 ). The syndrome typically starts with psychotic experiences, such as psychomotor agitation, anxiety, auditory hallucinations, and delusions of persecution and also classical catatonia can occur (Drachman and Adams 1962 ;Kapur et al 1994 ;Koehler and Guth 1979 ;Misra and Hay 1971 ;Raskin and Frank 1974 ;Schlitt et al 1985 ).…”

Section: Pathophysiology Of Herpes Simplex Encephalitismentioning

confidence: 99%

Microglia Activation, Herpes Infection, and NMDA Receptor Inhibition: Common Pathways to Psychosis?

Klein

Doorduin

Witte

et al. 2015

Current Topics in Neurotoxicity

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Microglia are the resident macrophages of the brain. Microglia play important housekeeping roles during brain development and during exposure to psychosocial stress, toxins, and infectious pathogens. The hippocampus is a vulnerable brain region in response to these external stressors. In patients with psychosis, we found a major activation of microglia in the hippocampus, which could explain in part the volume loss of the hippocampus after a psychotic episode of patients. Recent research suggests lowgrade replication of herpes simplex virus (HSV) as a potential environmental trigger of microglia activation in schizophrenia. A common mechanism of psychosis is proposed that involves activation of microglia by toxic, auto-immune, or infectious factors, converging to a blockade of the NMDA-NR1 receptor in the hippocampus.

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“…In some patients, the altered behaviour and psychotic episodes are first observed long before the onset of neurological symptoms (Schlitt, Lakeman, & Whitley, 1985;Wilson, 1976). In clinical practice this may delay the correct diagnosis.…”

Section: Psychiatric Symptomsmentioning

confidence: 99%

Neuropsychological sequelae of acute-onset sporadic viral encephalitis

Hokkanen

Launes

2007

Neuropsychological Rehabilitation

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Acute encephalitis is an inflammation of the brain parenchyma. In the USA, by estimation, 20,000 cases occur every year. A variety of cognitive deficits may persist after the acute stage, and they are often the sole cause of disability. Recent literature demonstrates the heterogeneity of both amnestic disorders and the outcome following encephalitis. Herpes simplex virus is the most commonly recognised single aetiology of sporadic encephalitis and it may be the cause of the most severe symptoms. Antiviral medication, however, seems to have improved the cognitive outcome when compared to the historical, untreated cases. The cognitive sequelae following herpes simplex virus encephalitis (HSVE) are best known and most commonly described, e.g., in textbooks, but they do not represent the typical symptomatology of encephalitis in general. Much less is unfortunately known about other types of encephalitis, those that account perhaps up to 80% of all cases, where both mild and severe defects have been observed. This article summarises the current knowledge.

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Psychosis and Herpes Simplex Encephalitis

Cited by 38 publications

References 0 publications

Acute Confusion—an Unusual Form of Cerebral Herpes Simplex Virus Infection?

Acute Confusion—an Unusual Form of Cerebral Herpes Simplex Virus Infection?

Microglia Activation, Herpes Infection, and NMDA Receptor Inhibition: Common Pathways to Psychosis?

Neuropsychological sequelae of acute-onset sporadic viral encephalitis

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