Journal article
Brainstem encephalitis: an unusual presentation of herpes simplex virus infection
Journal of neurology, Vol.257(9), pp.1432-1437
2010
DOI: 10.1007/s00415-010-5600-x
PMID: 20495814
Abstract
Herpes simplex virus (HSV) encephalitis has a predilection for the temporal and frontal lobes but occasionally affects the brainstem. We describe a patient who developed HSV brainstem encephalitis that progressed to quadriplegia. Using MEDLINE, we conducted a comprehensive review of other published cases of HSV brainstem encephalitis. Twenty-four published cases of HSV brainstem encephalitis met our inclusion criteria. The mean age was 41.4 years (range 18-71). HSV-1 was the etiologic agent in 79% of reported HSV brainstem encephalitis cases, and HSV-2 accounted for 21% of cases. Infection was limited to the brainstem in 29% of cases and multi-focal, including the brainstem, in 71%. Common manifestations of HSV brainstem encephalitis included neuro-ophthalmologic findings (81%), cranial nerve deficits (69%), and fever (69%). Quadriplegia, as occurred in our patient, was an unusual finding (19%). The mortality rate of HSV brainstem encephalitis was 41%. Intravenous acyclovir showed a beneficial effect on mortality (75% vs. 22%, p = 0.06). HSV brainstem encephalitis is a distinct type of HSV encephalitis. With the increasing use of HSV-PCR, more cases of HSV brainstem encephalitis may be identified. A greater recognition of this syndrome will help better define its optimal treatment and prognosis.
Details
- Title: Subtitle
- Brainstem encephalitis: an unusual presentation of herpes simplex virus infection
- Creators
- Daniel LIVORSI - Department of Infectious Disease, Emory University School of Medicine, 49 Jesse Hill Jr Drive, Atlanta, GA 30303, United StatesEric ANDERSON - Department of Neurology, Emory University School of Medicine, WMRB 6000, 1639 Pierce Dr NE, Atlanta, GA 30322, United StatesSakib QURESHI - Department of Neurology, Emory University School of Medicine, WMRB 6000, 1639 Pierce Dr NE, Atlanta, GA 30322, United StatesMarion HOWARD - Department of Internal Medicine, Emory University School of Medicine, 69 Jesse Hill Jr Drive SE, Atlanta, GA 30303, United StatesYun F WANG - Pathology and Laboratory Medicine, Grady Memorial Hospital, Emory University School of Medicine, P.O. Box 26248, 80 Jesse Hill Dr SE, Atlanta, GA 30303, United StatesCarlos FRANCO-PAREDES - Department of Infectious Disease, Emory University School of Medicine, 49 Jesse Hill Jr Drive, Atlanta, GA 30303, United States
- Resource Type
- Journal article
- Publication Details
- Journal of neurology, Vol.257(9), pp.1432-1437
- Publisher
- Springer
- DOI
- 10.1007/s00415-010-5600-x
- PMID
- 20495814
- ISSN
- 0340-5354
- eISSN
- 1432-1459
- Language
- English
- Date published
- 2010
- Academic Unit
- Infectious Diseases; Internal Medicine
- Record Identifier
- 9984094528602771
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