Corticosteroid-responsive focal granulomatous herpes simplex type-1 encephalitis in adults.
Pract Neurol
; 17(2): 140-144, 2017 Apr.
Article
em En
| MEDLINE
| ID: mdl-28153849
ABSTRACT
We describe corticosteroid-responsive focal granulomatous encephalitis as a manifestation of herpes simplex virus (HSV) type 1 disease in the brain something easily missed and easily treated. Two adult cases presented with cognitive symptoms progressing over weeks, despite aciclovir treatment. Brain imaging showed temporal lobe abnormalities, with gadolinium enhancement but no abnormal diffusion restriction. HSV-1 PCR analysis was negative in cerebrospinal fluid (CSF) but positive in brain biopsies, which showed vasocentric granulomatous inflammation. Paired blood and CSF samples showed intrathecal synthesis of HSV-1 type-specific IgG. The patients improved clinically only after immunosuppression. Despite profound cognitive impairment at their clinical nadir, both patients recovered fully. We suggest that, at least in a subset of patients with HSV-1 encephalitis, adjunctive corticosteroid treatment is critical to improve the outcome of the disease.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Corticosteroides
/
Herpesvirus Humano 1
/
Encefalite por Herpes Simples
Limite:
Female
/
Humans
/
Middle aged
Idioma:
En
Revista:
Pract Neurol
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
Reino Unido