The spectrum of aseptic central nervous system infections in southern Germany – demographic, clinical and laboratory findings

Abstract

Polymerase chain reaction tests for HSV, VZV and EV in CSF and TBE serology determined the causative virus in over 60% of tested patients. The age of affected patients, seasonal distribution, disease course and inflammatory changes in CSF differ between groups of patients affected by the most common viral infections.

Cerebrospinal fluid features in adults with enteroviral nervous system infection

“…In line with previous studies, meningitis was the main clinical manifestation of enteroviral nervous system infection (Han et al, 2016;Kaminski et al, 2017). Notably, 22% of the study patients with meningitis reported a sudden onset of headache that led to the initial suspected diagnosis of subarachnoidal haemorrhage.…”

“…Moreover, another five patients who presented clinically with meningitis also showed cranial nerve involvement. While cranial nerve involvement is common in children (Messacar et al, 2015), it has not been reported in clinical studies of adults with enteroviral CNS infection (Hong et al, 2014;Kaminski et al, 2017). However, sporadic cases of vestibulocochlear nerve disturbance in the context of enteroviral CNS infection have been described (Schattner et al, 2003).…”

“…To date, clinical and diagnostic characteristics of enteroviral CNS infections have mostly been investigated in studies that have included patients with different infectious agents of aseptic meningitis or encephalitis (Ihekwaba et al, 2008;Kaminski et al, 2017;Kupila et al, 2006;Nowak et al, 2003). Most of these studies were restricted to patients with aseptic meningitis (Ihekwaba et al, 2008;Nowak et al, 2003) and included patients with CSF pleocytosis (Hong et al, 2014;Kaminski et al, 2017) or those affected during epidemic outbreaks of a specific enterovirus serotype (Carrol et al, 2006).…”

“…Only a few studies have analyzed the full spectrum of neurological manifestations, demographic characteristics, and laboratory and imaging findings in adult patients with enteroviral nervous system infections (Kaminski et al, 2017;Nowak et al, 2003). As CSF findings in adult patients with enterovirus infection are still poorly defined, this study was performed to thoroughly evaluate the clinical and laboratory data with a special emphasis on the CSF.…”

Progress in neurology 2017–2018

“…Treatment modalities are limited, with the exception of the immune‐mediated diseases and those with a defined biochemical cause that lends itself to specific therapy such as Pompe disease . Immune‐mediated diseases of the central nervous system are a heterogenous group of disorders characterized by specific antibodies to central nervous system proteins such as the autoimmune encephalitides and neuromyelitis optica. Significant progress has been made in the diagnosis and treatment of these .…”