SPECT and MR Imaging in Herpes Simplex Encephalitis

Schmidbauer, Manfred; Podreka, I.; Wimberger, D.; Oder, W.; Koch, Gabriela; Wenger, S.; Goldenberg, Georg; Asenbaum, S.; Deecke, Lüder

doi:10.1097/00004728-199109000-00016

Cited by 37 publications

(15 citation statements)

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“…MRI has become the most sensitive and specific tool for the diagnosis of HSE (Schroth et al. , 1987; Schmidbauer et al. , 1991; Tien et al.…”

Section: Discussionmentioning

confidence: 99%

“…Low density lesions were shown by head CT scan in about 70% of cases a few days after onset of symptoms in one series (Hindmarsh et al, 1986). Temporal lobe lesions are typically shown by MRI as hypointense lesions on T1 weighted images and hyperintense lesions on T2 weighted images at an earlier stage than by CT (Schroth et al, 1987;Schmidbauer et al, 1991;Demaerel et al, 1992).…”

Section: Introductionmentioning

confidence: 99%

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Extra temporal involvement in herpes simplex encephalitis

Wasay

Mekan

Khelaeni

et al. 2005

Euro J of Neurology

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Temporal lobe abnormalities on brain imaging have been described as strong evidence for herpes simplex encephalitis (HSE) in appropriate clinical settings. Extra temporal abnormalities are less well described in these patients. We retrospectively reviewed 20 patients of HSE and found extra temporal involvement in 11 (55%) patients. Three patients (15 %) had pure extra temporal abnormalities. Twelve patients (60%) had temporal lobe involvement, four patients (20%) had pure temporal lobe involvement and five patients (25%) had normal CT/MRI scans. Our study suggests that extra temporal involvement on brain imaging is common in HSE and in a significant minority of the patients this can even be the sole abnormality.

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“…MRI has become the most sensitive and specific tool for the diagnosis of HSE (Schroth et al. , 1987; Schmidbauer et al. , 1991; Tien et al.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Extra temporal involvement in herpes simplex encephalitis

Wasay

Mekan

Khelaeni

et al. 2005

Euro J of Neurology

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“…Magnetic resonance imaging in relation to patients with herpes simplex encephalitis has so far been primarily used as an improved diagnostic tool in the acute management of such patients. [4][5] It has also been shown to be useful in monitoring recovery of lesion severity with time. 6 At the neuropsychological level, there have been several important single case or small group studies, of patients with herpes simplex encephalitis.7-'0 These studies have been valuable, but have been limited by the small sample sizes, the selection bias in the patient samples, the absence of a dedicated MRI protocol to examine closely limbic system structures, and the limited anatomical description of those structures that were damaged or spared by the infection.…”

Section: Introductionmentioning

confidence: 99%

Herpes simplex encephalitis: long term magnetic resonance imaging and neuropsychological profile.

Kapur

Barker

Burrows

et al. 1994

Journal of Neurology, Neurosurgery & Psychiatry

196

106

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The first comprehensive in vivo documentation of the long term profile of pathological and spared tissue is described in a group of 10 patients with a diagnosis of herpes simplex encephalitis, who were left with memory difficulties as a major residual sequel of their condition. With a dedicated MRI protocol, which included high resolution images of temporal lobe and limbic system areas, data are provided on structures that have recently gained importance as anatomical substrates for amnesia. The major features of the lesion profile were: (1) unilateral or bilateral hippocampal damage never occurred in isolation, and was often accompanied by damage to the parahippocampus, the amygdala, specific temporal lobe gyri, and the temporal poles; (2) the insula was always abnormal; (3) neocortical temporal lobe damage was usually unilateral or asymmetric. It never occurred in isolation, and was invariably associated with more medial pathological changes; (4) anterior and inferior temporal lobe gyri were damaged more often and more severely than posterior and superior temporal lobe gyri; (5) pronounced abnormality was often present in the substantia innominata (region of the basal forebrain/anterior perforated substance); (6) there was evidence of significant abnormality in the fornix; (7) there was evidence of damage to the mammillary bodies; (8) thalamic nuclei were affected in around 50% of cases, with damage usually unilateral; (9) frontal lobe damage was present in a few patients, and affected medial areas more than dorsolateral areas; (10) there was some involvement of the striatum, although this was usually unilateral and mild; (11)

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“…SPECT can be used to differentiate HaNDL from other conditions, such as focal meningoencephalitis, where an increase in radionuclide uptake is expected 11. SPECT does not differentiate between HaNDL and migraine, as there is reduction in radionuclide uptake in both conditions.…”

Section: Discussionmentioning

confidence: 99%

Getting a handle on complicated migraine

Abkur¹,

McGowan²,

Kearney³

et al. 2015

BMJ Case Reports

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We describe a case of a 45-year-old man who presented with a transient syndrome consisting of headache with neurological deficits. Neuroimaging including brain angiography was normal. Cerebrospinal fluid (CSF) analysis revealed an elevated protein and lymphocytic pleocytosis. The diagnosis of a syndrome of Headache and Neurological Deficits with CSF Lymphocytosis (HaNDL) was made after excluding all the other possible causes for the patient's presentation. He made an excellent recovery following a short course of naproxen sodium.

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SPECT and MR Imaging in Herpes Simplex Encephalitis

Cited by 37 publications

References 0 publications

Extra temporal involvement in herpes simplex encephalitis

Extra temporal involvement in herpes simplex encephalitis

Herpes simplex encephalitis: long term magnetic resonance imaging and neuropsychological profile.

Getting a handle on complicated migraine

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