Acute Viral Encephalitis: The Recent Progress.

Shoji, Hiroshi; Azuma, Koichi; Nishimura, Y.; Fujimoto, Hiroshi; Sugita, Yasuo; Eizuru, Yoshito

doi:10.2169/internalmedicine.41.420

Cited by 32 publications

(18 citation statements)

References 60 publications

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“…In addition, non-herpetic ALE has a favorable prognosis, unlike HSE and paraneoplastic limbic encephalitis. Non-herpetic ALE has been increasing in Japan in recent years (4).…”

Section: Introductionmentioning

confidence: 99%

Non-herpetic Acute Limbic Encephalitis: Cerebrospinal Fluid Cytokines and Magnetic Resonance Imaging Findings

et al. 2004

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ObjectiveNon-herpetic acute limbic encephalitis (non-herpetic ALE) is regarded as a new subgroup of limbic encephalitis. In the present study, clinical findings and cerebrospinal fluid (CSF) cytokines in patients with non-herpetic ALE were investigated.Patients and Methods For adult inpatients in our hospital and related hospitals from 1996 to 2001, nonherpetic ALE was examined according to the criteria described in this study. Six patients were diagnosed as having non-herpetic ALE, and their clinical data and magnetic resonance imaging (MRI) were analyzed. In the CSF samples of the 6 patients with non-herpetic ALE and 6 patients with herpes simplex encephalitis (HSE), the concentrations of tumor necrosis factor (TNF)-, interleukin (IL)-1 , IL-6, and interferon (IFN)-were determined using sandwich-type enzyme-linked immunosorbent assay (ELISA) kits.Results The six patients with non-herpetic ALE showed all the acute encephalitis features, such as fever, altered consciousness, seizures, memory impairment, and mild CSF pleocytosis. MRI demonstrated selective abnormal signals in the limbic system, including the bilateral hippocampi and amygdalae. The levels of CSF IL-6 and IFN-in patients with non-herpetic ALE were significantly lower than those in patients with HSE (p<0.05 and p<0.01, respectively). The levels of both TNF-and IL-1 were below the detection limits in both groups.Conclusion Six patients were newly diagnosed as having non-herpetic ALE in this study. These patients revealed both acute limbic encephalitis and MRI abnormalities in the bilateral hippocampi and amygdalae. IntroductionSince 1990, a survey of herpes simplex virus (HSV) central nervous system (CNS) infections has been conducted with the primary focus on adult inpatients in the Kyushu and Okinawa regions of Japan. In the course of the survey, nonherpetic acute limbic encephalitis (non-herpetic ALE) was identified as a new subgroup of limbic encephalitis along the spectrum that includes herpes simplex encephalitis (HSE) and paraneoplastic limbic encephalitis (1-3). In 1994, we described four patients with non-herpetic ALE; these patients differed from those with HSE in terms of the lack of evidence of HSV infection based on polymerase chain reaction (PCR) studies and enzyme-linked immunosorbent assay (ELISA or EIA) antibody testing, and demonstrated magnetic resonance imaging (MRI) findings localized to parts of the limbic system, such as the bilateral hippocampi and amygdalae. In addition, non-herpetic ALE has a favorable prognosis, unlike HSE and paraneoplastic limbic encephalitis. Non-herpetic ALE has been increasing in Japan in recent years (4).In acute viral encephalitis and meningitis, changes in the levels of various cytokines such as tumor necrosis factor (TNF)-, interleukin ( Non-herpetic Acute Limbic Encephalitis: Cerebrospinal Fluid Cytokines and Magnetic Resonance Imaging FindingsKyoko ASAOKA, Hiroshi SHOJI, Shinya NISHIZAKA, Mitsuyoshi AYABE, Toshi ABE*, Nobuhira OHORI**, Takashi ICHIYAMA*** and Yoshito EIZURU**** ORIGINA...

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“…In addition, non-herpetic ALE has a favorable prognosis, unlike HSE and paraneoplastic limbic encephalitis. Non-herpetic ALE has been increasing in Japan in recent years (4).…”

Section: Introductionmentioning

confidence: 99%

Non-herpetic Acute Limbic Encephalitis: Cerebrospinal Fluid Cytokines and Magnetic Resonance Imaging Findings

et al. 2004

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“…With more neurovirulent strains or in immunocompromised mice, the virus can progress from the brainstem to the cerebral hemispheres causing potentially lethal encephalitis. In humans, HSV-1 is the leading cause of sporadic encephalitis with lesions occurring most frequently in the temporal lobe and less frequently in the brainstem (Gilden et al 2007;Shoji et al 2002).…”

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confidence: 99%

CD8+ T cells patrol HSV-1-infected trigeminal ganglia and prevent viral reactivation

Leger

Hendricks

2011

J. Neurovirol.

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A hallmark of herpes viruses is their capacity to cause recurrent disease. Recurrences of herpes simplex virus (HSV)-1 disease do not result from reinfection from external sources, but rather from reactivation of virus that is maintained in a latent state in sensory neurons and periodically reactivates from latency to cause recurrent disease. Recent findings implicate HSV-specific CD8(+) T cells in immune surveillance of HSV-1 latently infected sensory neurons in trigeminal ganglia (TG) and inhibition of HSV-1 reactivation from latency. This review summarizes recent findings regarding the characteristics of the TG-resident CD8(+) T cell population and certain unique obstacles that might complicate the development of therapeutic vaccines.

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“…Although MRI findings were confined to the limbic systems on the left side, there was no evidence of herpetic viral infections, supporting the initial diagnosis of non-herpetic acute limbic encephalitis [7]. While the presence of various neurological manifestations, including neurogenic bladder, nystagmus, truncal ataxia and epilepsy, suggested multifocal lesions of the brain and spinal cord; taken together with antecedent infection, the clinical features in this patient, showing marked response to steroid therapy, were compatible with those of ADEM [1,6].…”

Section: Discussionmentioning

confidence: 71%

Acute disseminated encephalomyelitis with medial temporal lesions mimicking acute limbic encephalitis

Sakai

Yoshita

Samuraki

et al. 2011

Clinical Neurology and Neurosurgery

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Acute Viral Encephalitis: The Recent Progress.

Cited by 32 publications

References 60 publications

Non-herpetic Acute Limbic Encephalitis: Cerebrospinal Fluid Cytokines and Magnetic Resonance Imaging Findings

Non-herpetic Acute Limbic Encephalitis: Cerebrospinal Fluid Cytokines and Magnetic Resonance Imaging Findings

CD8+ T cells patrol HSV-1-infected trigeminal ganglia and prevent viral reactivation

Acute disseminated encephalomyelitis with medial temporal lesions mimicking acute limbic encephalitis

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