1,268 results match your criteria Imaging in Herpes Encephalitis

Adult-onset mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes (MELAS) syndrome with progressive sensorineural hearing loss: A case report.

Radiol Case Rep 2021 Jul 24;16(7):1865-1869. Epub 2021 May 24.

Deparment of Neurology, University Medical Centre, Ho Chi Minh City, Vietnam.

Mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS) syndrome is one of the most common maternally inherited mitochondrial disorders, with no specific treatment available. We report a case of a 34-year-old female in whom symptoms of MELAS were initially misdiagnosed as herpes simplex encephalitis (HSE). Her clinical course was marked by an acute episode of consciousness disturbance with newly developed lesions on brain MRI five years after disease onset and followed by progressive sensorineural hearing loss. Read More

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Anti-N-methyl-d-aspartate receptor encephalitis: A primer for acute care healthcare professionals.

J Intensive Care Soc 2021 May 25;22(2):95-101. Epub 2020 Mar 25.

Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.

This primer summarizes the diagnosis, treatment, complications, and prognosis of anti-N-methyl-d-aspartate receptor encephalitis for healthcare professionals, especially those in acute care specialities. Anti-N-methyl-d-aspartate receptor encephalitis is an immune-mediated encephalitis that is classically paraneoplastic and associated with ovarian teratomas in young women. Other less common neoplastic triggers include testicular cancers, Hodgkin lymphoma, lung and breast cancers. Read More

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The challenge of diagnosing and successfully treating anti-NMDA receptor encephalitis in a toddler.

Sudan J Paediatr 2021 ;21(1):76-81

Division of Pediatric Neurology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.

Anti-N-methyl-D-aspartate (anti-NMDA) receptor encephalitis is an immune-mediated syndrome that is still under-recognised, with grave consequences if not treated early. A multidisciplinary team approach is required in the process of diagnosis and management of this potentially treatable and reversible disorder. We report on a 26-month-old Sudanese girl who presented with focal seizures associated with fever (temperature = 38. Read More

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January 2021

Twice Negative PCR in a Patient With Herpes Simplex Virus Type 1 (HSV-1) Encephalitis.

Neurohospitalist 2021 Jan 22;11(1):66-70. Epub 2020 Jul 22.

Division of Neurology, Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Alberta, Canada.

Untreated herpes simplex virus type 1 (HSV-1) encephalitis is associated with high mortality. Missed cases can have devastating consequences. Detection of HSV-1 in cerebrospinal fluid (CSF) with polymerase chain reaction (PCR) is reported to have high sensitivity and specificity and is considered the diagnostic gold standard for HSV-1 encephalitis. Read More

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January 2021

Anti-N-Methyl-D-Aspartate receptor Encephalitis as a potential cause of worsening Herpes Simplex Virus Encephalitis.

J Pak Med Assoc 2021 Feb;71(2(A)):569-570

5th Year MBBS Student, Army Medical College, Rawalpindi, Pakistan.

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February 2021

Autoimmune encephalopathies presenting as dementia of subacute onset and rapid progression.

Ther Adv Neurol Disord 2021 19;14:1756286421998906. Epub 2021 Mar 19.

Departments of Neurology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA.

The terms autoimmune dementia and autoimmune encephalopathy may be used interchangeably; autoimmune dementia is used here to emphasize its consideration in young-onset dementia, dementia with a subacute onset, and rapidly progressive dementia. Given their potential for reversibility, it is important to distinguish the rare autoimmune dementias from the much more common neurodegenerative dementias. The presence of certain clinical features [e. Read More

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Untreated herpes simplex virus encephalitis without a fatal outcome.

J Neurovirol 2021 Mar 31. Epub 2021 Mar 31.

Department of Medical Microbiology, Medical School of Cerrahpasa, Istanbul University, Istanbul, Turkey.

Herpes simplex virus encephalitis (HSE) is the most common sporadic fatal encephalitis. Although timely administered acyclovir treatment decreases mortality, neuropsychiatric sequelae is still common among survivors. Magnetic resonance imaging is frequently utilized for the diagnosis of HSE, which typically involves temporal lobe(s) and can be mixed with brain tumors involving the same area. Read More

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Cryo-Electron Tomography of the Herpesvirus Procapsid Reveals Interactions of the Portal with the Scaffold and a Shift on Maturation.

mBio 2021 03 16;12(2). Epub 2021 Mar 16.

Laboratory of Structural Biology Research, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, Maryland, USA

Herpes simplex virus 1 (HSV-1) requires seven proteins to package its genome through a vertex in its capsid, one of which is the portal protein, pUL6. The portal protein is also thought to facilitate assembly of the procapsid. While the portal has been visualized in mature capsids, we aimed to elucidate its role in the assembly and maturation of procapsids using cryo-electron tomography (cryoET). Read More

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Recent developments on PET radiotracers for TSPO and their applications in neuroimaging.

Acta Pharm Sin B 2021 Feb 25;11(2):373-393. Epub 2020 Aug 25.

Division of Nuclear Medicine and Molecular Imaging, Massachusetts General Hospital & Department of Radiology, Harvard Medical School, Boston, MA 02114, USA.

The 18 kDa translocator protein (TSPO), previously known as the peripheral benzodiazepine receptor, is predominately localized to the outer mitochondrial membrane in steroidogenic cells. Brain TSPO expression is relatively low under physiological conditions, but is upregulated in response to glial cell activation. As the primary index of neuroinflammation, TSPO is implicated in the pathogenesis and progression of numerous neuropsychiatric disorders and neurodegenerative diseases, including Alzheimer's disease (AD), amyotrophic lateral sclerosis (ALS), Parkinson's disease (PD), multiple sclerosis (MS), major depressive disorder (MDD) and obsessive compulsive disorder (OCD). Read More

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February 2021

Multimodal Imaging of a Severe Case of Neonatal Acute Retinal Necrosis and Lens Vacuoles Associated with Herpes Simplex Virus Infection.

Ocul Immunol Inflamm 2021 Feb 4:1-7. Epub 2021 Feb 4.

Department of Ophthalmology, Sapporo City General Hospital, Sapporo, Japan.

Purpose: To report a case of a neonate with acute retinal necrosis, lens vacuoles, and encephalitis associated with herpes simplex virus (HSV) infection.

Design: Case report.

Methods: Retrospective chart review. Read More

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February 2021

Clinical significance of Epstein-Barr virus in the cerebrospinal fluid of immunocompetent patients.

Clin Neurol Neurosurg 2021 Mar 19;202:106507. Epub 2021 Jan 19.

Department of Neurology, Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea; Department of Neurology, Pusan National University Yangsan Hospital, Pusan National University, Yangsan, Republic of Korea.

Introduction: Polymerase chain reaction (PCR)-based testing of cerebrospinal fluid (CSF) samples has greatly facilitated the diagnosis of central nervous system (CNS) infections. However, the clinical significance of Epstein-Barr virus (EBV) DNA in CSF of individuals with suspected CNS infection remains unclear. We wanted to gain a better understanding of EBV as an infectious agent in immunocompetent patients with CNS disorders. Read More

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Wiad Lek 2020 ;73(11):2555-2556


Ramsay Hunt syndrome (RHS) occurs due to reactivation of latent Varicella Zoster Virus (VZV) infection in the geniculate ganglion of the facial nerve. Major clinical symptoms include ipsilateral facial paralysis, otic pain, and herpetic vesicles (rashes) along the nerve with accompanying ear pain. Rarely clinical findings include retrograde transaxonal spread of the virus from the ganglion into the brain parenchyma with developing the encephalitis or multiple cranial nerve involvement. Read More

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January 2021

HSV encephalitis triggered anti-NMDAR encephalitis: a case report.

Neurol Sci 2021 Mar 8;42(3):857-861. Epub 2021 Jan 8.

Neurology Department of Shenzhen Second People's Hospital/First Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen, 518035, China.

Background: Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis (AE) is a common cause of nonviral infectious encephalitis, which can be triggered by herpes simplex virus infection. Previous studies have shown that approximately 27% of herpes simplex encephalitis (HSE) patients produce anti-NMDAR antibodies within 3 months. Immunotherapy is recommended in this situation, but some symptoms usually remain in the 1-year follow-up. Read More

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Varicella-Zoster Virus Meningitis and Encephalitis: An Understated Cause of Central Nervous System Infections.

Cureus 2020 Nov 20;12(11):e11583. Epub 2020 Nov 20.

Internal Medicine, University of Sucre, Sincelejo, COL.

Background Varicella-zoster virus (VZV) and herpes zoster cause infections of the central nervous system (CNS) manifesting as meningitis or encephalitis. As compared to enterovirus (EV) and herpes simplex virus 1 (HSV-1) and 2 (HSV-2), it is not often tested in CNS infections due to VZV and herpes zoster. There is a certain tendency to think that the findings in the cerebrospinal fluid in infections of the CNS by viruses are comparable among themselves. Read More

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November 2020

50 Years Ago in TheJournalofPediatrics: Herpes Simplex Encephalitis: No Longer a Brain-Teaser.

J Pediatr 2021 01;228:81

Department of Pediatrics, University College of Medical Sciences, Delhi, India.

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January 2021

An adolescent with herpes simplex encephalitis, presenting with mild symptoms and rapid deterioration: A case report.

SAGE Open Med Case Rep 2020 6;8:2050313X20977142. Epub 2020 Dec 6.

Department of Pediatrics, Medical University of Vienna, Vienna, Austria.

Headaches in children are a common, but unspecific symptom that can have many underlying causes, ranging from unspecific tension headache through migraine and up to encephalitis and intracranial hypertension. We present the case of a 14-year-old boy who presented to our emergency department with headache, nausea as well as vomiting and developed seizures later on. The initial diagnosis was complicated by a magnetic resonance imaging which did not show any signs of inflammation, but was of limited informative value due to orthodontic appliances. Read More

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December 2020

[Co-existence of Guillain-Barré syndrome and Behcet syndrome: A case report].

C Yu C Li Y Y Fan Y Xu

Beijing Da Xue Xue Bao Yi Xue Ban 2020 Dec;52(6):1146-1149

Department of Neurology, Peking University People's Hospital, Beijing 100044, China.

A 40-year-old male patient was referred to our department with complains of recurrent oral ulcer for more than 20 years and vulvar ulcer for more than 10 years. He presented with a 3-month history of right external ophthalmoplegia. More than 10 days ago, the patient received ganglioside infusion. Read More

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December 2020

[Herpes simplex virus type 2 encephalitis in a healthy adult patient: an unusual case].

Rev Peru Med Exp Salud Publica 2020 Dec;37(3):566-570

Universidad Peruana Cayetano Heredia, Lima, Perú.

Neurological infection by herpes simplex virus type 2 (HSV-2) is the cause of significant morbidity and mortality; and should be diagnosed and treated as soon as possible. Typically, it is characterized by fever, headache and behavioral changes. Symptoms association, laboratory tests results and diagnostic imaging are essential for early diagnosis and treatment of this disease, in order to prevent its fatal progression. Read More

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December 2020

[An autopsy case of elderly-onset herpes simplex encephalitis with acute respiratory failure caused by brainstem lesions].

Rinsho Shinkeigaku 2020 Dec 20;60(12):840-845. Epub 2020 Nov 20.

Department of Neurology, Toyonaka Municipal Hospital.

An 89-year-old man was admitted because of persistent fever and impaired consciousness. On admission, his consciousness level was E3V3M4 according to the Glasgow Coma Scale. MRI of the brain showed high intensity lesions in the bilateral cingulate gyri. Read More

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December 2020

Encephalitis with coinfection by Jamestown canyon virus (JCV) and varicella zoster virus (VZV).

IDCases 2020 8;22:e00966. Epub 2020 Oct 8.

Department of Medicine, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MI USA.

We present the case of a 59-year-old Midwestern farmer who presented with altered mental status, dysarthria, urinary incontinence, and a right-sided L5 dermatomal rash; he had recently received a course of oral corticosteroids for treatment of radicular low back pain. Lumbar puncture revealed the presence of varicella zoster virus (VZV) and IgM antibodies against a California-group encephalitis virus, later confirmed as Jamestown Canyon virus (JCV). Unfortunately, the patient's health declined despite aggressive treatment, developing progressive subarachnoid hemorrhage. Read More

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October 2020

Magnetic Resonance Vessel Wall Imaging in Central Nervous System Vasculitides: A Case Series.

Neurologist 2020 Nov;25(6):174-177

Departments of Neurology.

Introduction: We aim to report 3 cases of central nervous system (CNS) vasculitides, in which high-resolution magnetic resonance vessel wall imaging (HR-VWI) findings were instrumental in the diagnosis and management.

Case Report: Case 1: A 41-year-old obese, smoker female with arterial hypertension presented with recurrent transient ischemic attacks. Computed topography angiography demonstrated bilateral middle cerebral artery (MCA) stenosis. Read More

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November 2020

Cerebrovascular complications and vasculopathy in patients with herpes simplex virus central nervous system infection.

J Neurol Sci 2020 Dec 22;419:117200. Epub 2020 Oct 22.

Cerebrovascular Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, United States of America. Electronic address:

Objective: Herpes simplex viruses (HSV) are neurotropic and known to cause central nervous system (CNS) infections. We aimed to describe the clinical and imaging features of cerebrovascular complications in patients with HSV CNS infections.

Methods: We reviewed records of patients with HSV infections by querying acyclovir use in a clinical registry of parenteral anti-infective therapy at a tertiary medical center from January 2010 until September 2018. Read More

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December 2020

Acute myelitis and SARS-CoV-2 infection. A new etiology of myelitis?

J Clin Neurosci 2020 Oct 30;80:280-281. Epub 2020 Sep 30.

Oncology Service of Hospital General de Ciudad Real, Spain.

The etiological agent of coronavirus disease-19 (COVID-19), SARS-coronavirus-2 (SARS-CoV-2), emerged in Wuhan, China, and quickly spread worldwide leading the World Health Organization (WHO) to recognize it not only as a pandemic but also as an important thread to public health. Beyond respiratory symptoms, new neurological manifestations are being identified such as headache, ageusia, anosmia, encephalitis or acute cerebrovascular disease. Here we report the case of an acute transverse myelitis (TM) in a patient with SARS-CoV-2 infection detected by the nasopharyngeal swab technique but not in cerebrospinal fluid (CSF) analysis. Read More

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October 2020

Epidemiology, Etiology and Clinical Aspects of Childhood Acute Encephalitis in a Tertiary Pediatric Hospital in Costa Rica.

Pediatr Infect Dis J 2021 Mar;40(3):186-190

Infectious Disease Department, Hospital Nacional de Niños "Dr. Carlos Sáenz Herrera," Centro de Ciencias Médicas de la Caja Costarricense del Seguro Social, San José, Costa Rica.

Background: Limited data are available on childhood encephalitis in Latin America. Our study aimed to increase insight on clinical presentation, etiology and outcome of children with acute encephalitis in Costa Rica.

Methods: We conducted a prospective, observational study during an 8-month period at the Hospital Nacional de Niños "Dr. Read More

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Tick-Borne Encephalitis: A Differential Pattern of Intrathecal Humoral Immune Response and Inflammatory Cell Composition Compared with Other Viral CNS Infections.

Cells 2020 09 25;9(10). Epub 2020 Sep 25.

Department of Neurology, University of Ulm, 89081 Ulm, Germany.

To investigate whether and how cerebrospinal fluid (CSF) findings can contribute to distinguish tick-borne encephalitis (TBE) from herpes simplex virus (HSV) and varicella zoster virus (VZV) induced central nervous system (CNS) infections (HSV-I, VZV-I). Chart review and identification of TBE, HSV- I, and VZV-I was carried out, fulfilling the following criteria: (1) clinical signs of encephalitis and/or meningitis, (2) complete CSF analysis and confirmed viral etiology by either PCR or antibody testing in CSF, (3) hospitalized patients, and (4) available brain magnetic resonance imaging (MRI). Fifty-nine patients with 118 CSF/serum pairs were included. Read More

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September 2020

A middle-aged woman with acute onset of fever, altered mental status, and movement disorder.

Yusaku Kajihara

Eur J Intern Med 2020 12 26;82:116-117. Epub 2020 Sep 26.

Department of Gastroenterology, Fuyoukai Murakami Hospital, Japan. Electronic address:

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December 2020

Cerebrospinal fluid biomarkers of brain injury, inflammation and synaptic autoimmunity predict long-term neurocognitive outcome in herpes simplex encephalitis.

Clin Microbiol Infect 2020 Sep 23. Epub 2020 Sep 23.

Institute of Biomedicine, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden; Department of Infectious Diseases, Sahlgrenska University Hospital, Gothenburg, Sweden.

Objectives: The aim was to investigate the correlation between biomarkers of brain injury and long-term neurocognitive outcome, and the interplay with intrathecal inflammation and neuronal autoimmunity, in patients with herpes simplex encephalitis (HSE).

Methods: A total of 53 adult/adolescent HSE patients were included from a prospective cohort in a randomized placebo-controlled trial investigating the effect of a 3-month follow-up treatment with valaciclovir. Study subjects underwent repeated serum/cerebrospinal fluid (CSF) sampling and brain magnetic resonance imaging in the first 3 months along with cognitive assessment using the Mattis Dementia Rating Scale (MDRS) at 24 months. Read More

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September 2020

Herpes simplex encephalitis in a patient with a distinctive form of inherited IFNAR1 deficiency.

J Clin Invest 2021 Jan;131(1)

Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Paris, France.

Inborn errors of TLR3-dependent IFN-α/β- and IFN-λ-mediated immunity in the CNS can underlie herpes simplex virus 1 (HSV-1) encephalitis (HSE). The respective contributions of IFN-α/β and IFN-λ are unknown. We report a child homozygous for a genomic deletion of the entire coding sequence and part of the 3'-UTR of the last exon of IFNAR1, who died of HSE at the age of 2 years. Read More

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January 2021

An adult case of parainfectious optic neuritis associated with genital herpes simplex virus type 2 infection.

Clin Neurol Neurosurg 2020 11 9;198:106200. Epub 2020 Sep 9.

Department of Neurology and Strokology, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan.

Although acute retinal necrosis (ARN) and optic neuritis following herpes encephalitis are known causes of acute visual impairment associated with herpes simplex virus (HSV) infection, there have been no reports of parainfectious optic neuritis associated with genital HSV type 2 (HSV-2) infection. A young Japanese woman developed unilateral optic neuritis 7 days after the onset of genital HSV-2 infection. Ophthalmologic examination revealed no findings suggestive of ARN and both multiple sclerosis and neuromyelitis optica were ruled out by the brain images and serum antibody testing. Read More

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November 2020