MRI deterioration in herpes simplex encephalitis despite clinical recovery (Journal article)

Markoula, S./ Giannopoulos, S./ Pelidou, S. H./ Argyropoulou, M./ Lagos, G./ Kyritsis, A. P.

OBJECTIVES: Herpes simplex virus type 1 is a sporadic cause of viral encephalitis. Relapse of encephalitis occurs in up to 10% of patients, manifested by recurrent symptoms, clinical and MRI findings, and the presence of herpes simplex virus type 1 DNA in the cerebrospinal fluid (CSF). METHODS: We describe the clinical features, MRI findings and outcome in 2 patients with herpes simplex encephalitis during the acute phase and 6 months after the onset of encephalitis. RESULTS: Both patients had a good response to treatment and an excellent recovery. Despite clinical recovery, in a 6-month follow-up MRI lesions consistent with recurrence were disclosed, without any clinical findings or CSF abnormalities. CONCLUSIONS: The mechanism underlying this MRI deterioration is unclear and an immune-mediated mechanism may be involved. Thus, MRI deterioration after herpes simplex encephalitis should be interpreted with caution and it does not always represent a relapse, especially when the imaging studies do not correlate with the clinical and CSF findings.
Institution and School/Department of submitter: Πανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικής
Keywords: Acyclovir/therapeutic use,Anticonvulsants/therapeutic use,Antiviral Agents/therapeutic use,Brain/*pathology/radiography/*virology,Cerebral Cortex/pathology,Chronic Disease/drug therapy,Disease Progression,Encephalitis, Herpes Simplex/immunology/*pathology/physiopathology,Female,Frontal Lobe/pathology,Gyrus Cinguli/pathology,Humans,Magnetic Resonance Imaging,Male,Middle Aged,Nerve Fibers, Myelinated/pathology,Recovery of Function/immunology,Recurrence,Retrospective Studies,Temporal Lobe/pathology,Tomography, X-Ray Computed,Treatment Outcome
URI: https://olympias.lib.uoi.gr/jspui/handle/123456789/19905
ISSN: 1074-7931
Link: http://www.ncbi.nlm.nih.gov/pubmed/19590384
Appears in Collections:Άρθρα σε επιστημονικά περιοδικά ( Ανοικτά)

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