Respiratory syncytial virus-related encephalitis: magnetic resonance imaging findings with diffusion-weighted study: response to a “letter to the editor”

Park, Arim; Suh, Sangil

doi:10.1007/s00234-014-1341-3

Cited by 3 publications

(3 citation statements)

References 5 publications

(5 reference statements)

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“…Briefly, four studies were performed in the USA [ 52 , 53 , 55 , 81 ], with three further studies from South Korea [ 84 ], Turkey [ 92 ], and the United Kingdom [ 82 ]. Mirroring the broad timeframe of the parent studies (ranging from 1994 to 2016), diagnosis of RSV infection was performed by means of either IIF + viral cultures [ 52 , 81 , 82 ] or RT-qPCR [ 53 , 55 , 83 , 84 ].…”

Section: Resultsmentioning

confidence: 99%

Occurrence of Central Nervous System Complications of Respiratory Syncytial Virus Infections: A Systematic Review with Meta-Analysis

Riccò,

Cascio,

Corrado

et al. 2024

Epidemiologia

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An increasing base of evidence suggests that respiratory syncytial virus (RSV) infections may be associated with neurological complications. In accord with the PRISMA statement, we performed a systematic review and meta-analysis on the occurrence of encephalitis and encephalopathy associated with documented RSV infections. PubMed, Embase, and Scopus databases were searched for eligible observational studies published up to 10 April 2024. Raw data included the occurrence of RSV infections among cases of encephalitis and/or encephalopathy and cases of encephalitis and/or encephalopathy among series of RSV infections. Data were pooled in a random effects model. Case reports were also collected, and their data pooled as a cumulative series. Heterogeneity was assessed using the I2 measure, while reporting bias was assessed by means of funnel plots and regression analysis. A total of 15 studies for a total of 7719 RSV infections and 1631 cases of encephalitis were analyzed. Moreover, 27 case reports and case series were retrieved, for a total of 84 individual cases of encephalitis/encephalopathy occurring during a documented RSV infection. A pooled prevalence of 2.20 cases of encephalitis/encephalopathy per 100 RSV cases (I2 = 99%) was calculated, while a prevalence of RSV infections among cases of encephalitis/encephalopathy was estimated to 3.53 per 100 cases for studies on respiratory specimens (I2 = 48%) and 0.37 per cases on central nervous system (CNS) specimens (I2 = 0%). Detection of RSV within the CNS was relatively rare (17.86% of pooled case reports), being associated with male gender (adjusted odds ratio [aOR] 5.021, 95% confidence interval [95%CI] 1.104 to 22.831) and recovery with long-term sequelae (aOR 5.699, 95%CI 1.152; 28.183). Case fatality ratio was estimated to be 0.43 per 100 cases on observational studies and 10.71% in case reports, a difference likely due to publication bias. In summary, RSV represented a not frequent but notable cause of encephalitis/encephalopathy in adults and children. The paucity of available studies not only recommends a cautious appraisal of our results but stresses the clinical significance of future studies on incident cases of encephalitis and/or encephalopathy.

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Section: Resultsmentioning

confidence: 99%

Occurrence of Central Nervous System Complications of Respiratory Syncytial Virus Infections: A Systematic Review with Meta-Analysis

Riccò,

Cascio,

Corrado

et al. 2024

Epidemiologia

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“…The hRSV, which induces a respiratory illness in infants, also alters the neurologic homeostasis with seizures, ataxia, and other encephalopathy symptoms (Espinoza et al 2013). It translocates from the lung to invade the CNS through a hematogenous/blood-brain barrier route and releases humoral neurotoxic cytokine mediators (Park and Suh 2014). The hMPV respiratory pathogen severely infects newborns' respiratory systems and immunocompromised individuals (Shafagati and Williams 2018;Edwards et al 2013).…”

Section: Discussionmentioning

confidence: 99%

Altered gene expression in human brain microvascular endothelial cells in response to the infection of influenza H1N1 virus

et al. 2022

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Influenza viruses not only cause respiratory illness, but also have been reported to elicit neurological manifestations following acute viral infection. The central nervous system (CNS) has a specific defense mechanism against pathogens structured by cerebral microvasculature lined with brain endothelial cells to form the blood–brain barrier (BBB). To investigate the response of human brain microvascular endothelial cells (hBMECs) to the Influenza A virus (IAV), we inoculated the cells with the A/WSN/33 (H1N1) virus. We then conducted an RNAseq experiment to determine the changes in gene expression levels and the activated disease pathways following infection. The analysis revealed an effective activation of the innate immune defense by inducing the pattern recognition receptors (PRRs). Along with the production of proinflammatory cytokines, we detected an upregulation of interferons and interferon-stimulated genes, such as IFN-β/λ, ISG15, CXCL11, CXCL3 and IL-6, etc. Moreover, infected hBMECs exhibited a disruption in the cytoskeletal structure both on the transcriptomic and cytological levels. The RNAseq analysis showed different pathways and candidate genes associated with the neuroactive ligand-receptor interaction, neuroinflammation, and neurodegenerative diseases, together with a predicted activation of the neuroglia. Likewise, some genes linked with the mitochondrial structure and function displayed a significantly altered expression. En masse, this data supports that hBMECs could be infected by the IAV, which induces the innate and inflammatory immune response. The results suggest that the influenza virus infection could potentially induce a subsequent aggravation of neurological disorders.

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“…Another study in Korea by Park et al [16] reported that the incidence of RSV-associated encephalitis was 0.08%. The same study showed that RSV-associated brain magnetic resonance imaging (MRI) findings may resemble those of other viral and limbic encephalitis, and no abnormality on diffusion-weighted imaging (DWI) was found [16,17].…”

Section: Introductionmentioning

confidence: 99%

Respiratory syncytial virus-associated seizures in Korean children, 2011–2016

Cha

Choi

et al. 2019

Korean J Pediatr

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Purpose Respiratory syncytial virus (RSV) infection can cause various neurological complications. This study aimed to investigate the RSV-associated neurologic manifestations that present with seizures. Methods We retrospectively reviewed the medical records of patients aged less than 15 years with laboratory-confirmed RSV infections and seizures between January 2011 and December 2016 in a regional hospital in South Korea. Results During this period, 1,193 patients with laboratory-confirmed RSV infection were identified. Of these, 35 (35 of 1,193, 2.93%; boys, 19; girls, 16; mean age: 20.8±16.6 months) presented with seizure. Febrile seizure was the most common diagnosis (27 of 35, 77.1%); simple febrile seizures in 13 patients (13 of 27, 48.1%) and complex febrile seizures in 14 (14 of 27, 51.9%). Afebrile seizures without meningitis or encephalopathy were observed in 5 patients (5 of 35, 14.3%), seizures with meningitis in 2 (2 of 35, 5.7%), and seizure with encephalopathy in 1 (1 of 35, 2.9%) patient. Lower respiratory symptoms were not observed in 8 patients. In a patient with encephalopathy, brain diffusion-weighted magnetic resonance imaging revealed transient changes in white matter, suggesting cytotoxic edema as the mechanism underlying encephalopathy. Most patients recovered with general management, and progression to epilepsy was noted in only 1 patient. Conclusion Although febrile seizures are the most common type of seizure associated with RSV infection, the proportion of patients with complex febrile seizures was higher than that of those with general febrile seizures. Transient cytotoxic edema may be a pathogenic mechanism in RSV-related encephalopathy with seizures.

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Respiratory syncytial virus-related encephalitis: magnetic resonance imaging findings with diffusion-weighted study: response to a “letter to the editor”

Cited by 3 publications

References 5 publications

Occurrence of Central Nervous System Complications of Respiratory Syncytial Virus Infections: A Systematic Review with Meta-Analysis

Occurrence of Central Nervous System Complications of Respiratory Syncytial Virus Infections: A Systematic Review with Meta-Analysis

Altered gene expression in human brain microvascular endothelial cells in response to the infection of influenza H1N1 virus

Respiratory syncytial virus-associated seizures in Korean children, 2011–2016

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