Electroencephalography in Diagnosis of Herpes-Simplex Encephalitis

Upton, A.R.M.; Gumpert, John

doi:10.1016/s0140-6736(70)90887-1

Cited by 106 publications

(30 citation statements)

References 17 publications

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“…Periodic discharges at low frequencies are a hallmark of many types of CNS disorders associated with transient and permanent cell loss (Niedermeyer, 2005). Delayed onset and recovery of EEG during recovery from CNS disease has been observed for example in case of herpes simplex infections (Upton and Gumpert, 1970;Illis and Taylor, 1972). In additional, albeit indirect, support of our hypothesis, frontal white matter volume and amplitude of resting delta EEG oscillations (1.5-4 Hz) show negative correlation in patients with mild cognitive impairment and Alzheimer's disease (Fernandez et al, 2003;Babiloni et al, 2006).…”

Section: Discussionsupporting

confidence: 78%

Pathological Effect of Homeostatic Synaptic Scaling on Network Dynamics in Diseases of the Cortex

Fröhlich¹,

Bazhenov²,

Sejnowski³

2008

J. Neurosci.

102

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Slow periodic EEG discharges are common in CNS disorders. The pathophysiology of this aberrant rhythmic activity is poorly understood. We used a computational model of a neocortical network with a dynamic homeostatic scaling rule to show that loss of input (partial deafferentation) can trigger network reorganization that results in pathological periodic discharges. The decrease in average firing rate in the network by deafferentation was compensated by homeostatic synaptic scaling of recurrent excitation among pyramidal cells. Synaptic scaling succeeded in recovering the network target firing rate for all degrees of deafferentation (fraction of deafferented cells), but there was a critical degree of deafferentation for pathological network reorganization. For deafferentation degrees below this value, homeostatic upregulation of recurrent excitation had minimal effect on the macroscopic network dynamics. For deafferentation above this threshold, however, a slow periodic oscillation appeared, patterns of activity were less sparse, and bursting occurred in individual neurons. Also, comparison of spike-triggered afferent and recurrent excitatory conductances revealed that information transmission was strongly impaired. These results suggest that homeostatic plasticity can lead to secondary functional impairment in case of cortical disorders associated with cell loss.

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Section: Discussionsupporting

confidence: 78%

Pathological Effect of Homeostatic Synaptic Scaling on Network Dynamics in Diseases of the Cortex

Fröhlich¹,

Bazhenov²,

Sejnowski³

2008

J. Neurosci.

102

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“…(4) The PCs are of transient nature. Their disappear ance is not a sign of clinical improvement or therapeutic success [Chatrian ct al., 1963;Upton and Gumpert. 1970;Kugler et al, 1976).…”

Section: Discussionmentioning

confidence: 99%

How Specific Are Periodic Complexes in the Diagnosis of <i>Herpes simplex </i>Encephalitis?

1984

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The specificity of localized periodic complexes (PC) in the EEG is discussed by means of a case. This patient presented rapidly evolving focal symptoms of the CNS together with fever. The EEG showed localized PCs and in the CT scan there was a hyperdense lesion in a region corresponding to the EEG finding. Postmortem examination revealed a subcortical bleeding in the temporal region. Possible mechanisms for the origin of these PCs and their diagnostic value are discussed.

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“…Seizures and epilepsy in the setting of HSVE have recently been reviewed [87]. Periodic discharges in HSVE have been observed generally between days 2 and 15 and may manifest before structural lesions can be observed on CT [88,89]. While EEG is recommended as part of the diagnostic evaluation of patients with encephalitis, there are few studies characterizing the contribution of EEG to diagnosis and prognosis in these patients, particularly in the era of MRI.…”

Section: Eegmentioning

confidence: 99%

Herpes Simplex Virus-1 Encephalitis in Adults: Pathophysiology, Diagnosis, and Management

2016

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Herpetic infections have plagued humanity for thousands of years, but only recently have advances in antiviral medications and supportive treatments equipped physicians to combat the most severe manifestations of disease. Prompt recognition and treatment can be lifesaving in the care of patients with herpes simplex-1 virus encephalitis, the most commonly identified cause of sporadic encephalitis worldwide. Clinicians should be able to recognize the clinical signs and symptoms of the infection and familiarize themselves with a rational diagnostic approach and therapeutic modalities, as early recognition and treatment are key to improving outcomes. Clinicians should also be vigilant for the development of acute complications, including cerebral edema and status epilepticus, as well as chronic complications, including the development of autoimmune encephalitis associated with antibodies to the N-methyl-D-aspartate receptor and other neuronal cell surface and synaptic epitopes. Herein, we review the pathophysiology, differential diagnosis, and clinical and radiological features of herpes simplex virus-1 encephalitis in adults, including a discussion of the most common complications and their treatment. While great progress has been made in the treatment of this life-threatening infection, a majority of patients will not return to their previous neurologic baseline, indicating the need for further research efforts aimed at improving the long-term sequelae.

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Electroencephalography in Diagnosis of Herpes-Simplex Encephalitis

Cited by 106 publications

References 17 publications

Pathological Effect of Homeostatic Synaptic Scaling on Network Dynamics in Diseases of the Cortex

Pathological Effect of Homeostatic Synaptic Scaling on Network Dynamics in Diseases of the Cortex

How Specific Are Periodic Complexes in the Diagnosis of <i>Herpes simplex </i>Encephalitis?

Herpes Simplex Virus-1 Encephalitis in Adults: Pathophysiology, Diagnosis, and Management

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