AI Article Synopsis
- Differentiating between human herpesvirus 6 (HHV-6) encephalopathy and herpes simplex encephalitis (HSE) is crucial as they involve similar brain areas but respond differently to treatment.
- In a study comparing eight HHV-6 encephalopathy cases with nine HSE cases, researchers analyzed brain imaging over three stages of symptom progression, focusing on MRI and CT findings.
- Results indicated that HHV-6 encephalopathy showed only mesial temporal lobe involvement and transient imaging abnormalities, while HSE had broader brain involvement with persistent abnormalities on MRI and abnormal CT findings early on.
Article Abstract
Objective: It is important to differentiate human herpesvirus 6 (HHV-6)-associated encephalopathy from herpes simplex encephalitis (HSE). Although these conditions are similar with regard to involvement of the mesial temporal lobe, HSE is sensitive to acyclovir but HHV-6 encephalopathy is not. We compared the imaging findings of the two conditions.
Materials And Methods: We encountered eight cases of HHV-6 encephalopathy and nine cases of HSE. We divided an observation time into early, middle, and late periods defined as 0-2, 3-30, and more than 30 days from the onset of neurologic symptoms. Differences between HHV-6 encephalopathy and HSE on CT scans in the early period and in distribution and temporal changes in the affected regions on MR images in the three periods were analyzed.
Results: At MRI in the early and middle periods, all eight patients with HHV-6 encephalopathy had exclusive involvement of the mesial temporal lobes, and all nine patients with HSE had involvement of both the mesial temporal lobes and the extratemporal regions (p < 0.01). Among patients who underwent head MRI, six of six with HHV-6 encephalopathy but none of six with HSE had resolution of high signal intensity on T2-weighted and FLAIR images (p < 0.01). Among patients who underwent head CT in the early period, none of the four with HHV-6 encephalopathy and six of the seven with HSE had abnormal findings, including parenchymal swelling, decreased attenuation of affected regions, and abnormal gyral enhancement (p < 0.05).
Conclusion: Serial MRI showed transient abnormal signal intensity in the mesial temporal lobes in patients with HHV-6 encephalopathy but persistent abnormal signal intensity in both the mesial temporal lobes and the extratemporal regions in patients with HSE. CT in the early period showed no abnormality in patients with HHV-6 encephalopathy but definite abnormal findings in patients with HSE. These differences may be useful in the differential diagnosis of the two conditions.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.2214/AJR.09.2548 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Chronic Lymphocytic Leukemia Infiltrating in the Brain.
Cureus
November 2024
Neurology, Mayo Clinic, Rochester, USA.
While earlier post-mortem studies show involvement of the central nervous system in 71% of patients with chronic lymphocytic leukemia (CLL), involvement intravitam is rare. A 72-year-old man with untreated, minimally symptomatic CLL developed subacute-onset encephalopathy and presented with severe hyponatremia and stress-induced cardiomyopathy. His initial head computed tomography scan was unremarkable.
View Article and Find Full Text PDFAssociation between human herpesviruses infections and childhood neurodevelopmental disorders: insights from two-sample mendelian randomization analyses and systematic review with meta-analysis.
Ital J Pediatr
November 2024
Pediatric Neurorehabilitation Center, Pediatric Department, The First Affiliated Hospital of Anhui Medical University, Hefei, China.
Article Synopsis
- The study investigates the relationship between human herpesviruses (HHVs) and neurodevelopmental disorders (NDDs) in children, focusing on autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), and Tourette syndrome (TS).
- Using a two-sample Mendelian randomization and meta-analysis approach, the research examines existing genetic data and observational studies to assess potential links between HHVs infection and these disorders.
- Results indicated that while there was no genetic evidence connecting HHVs to NDDs, some observational studies showed associations between specific HHVs and ASD, highlighting the need for further research to clarify these relationships.
The Development of Epilepsy Following CNS Viral Infections: Mechanisms.
Curr Neurol Neurosci Rep
November 2024
Neuroscience Department, Meyer Children's Hospital IRCCS, Viale Pieraccini 24, 50139, Florence, Italy.
Purpose Of Review: This review examines the role of different viral infections in epileptogenesis, with a focus on Herpesviruses such as Human Herpesvirus 6 (HHV-6) and Epstein Barr Virus (EBV), Flaviviruses, Picornaviruses, Human Immunodeficiency Virus (HIV), Influenzavirus and Severe Acute Respiratory Syndrome CoronaVirus 2 (SARS-CoV-2).
Recent Findings: A growing literature on animal models, such as the paradigmatic Theiler's murine encephalomyelitis virus (TMEV) model, and clinical investigations in patients with epilepsy have started to elucidate cellular mechanisms implicated in seizure initiation and development of epilepsy following viral infections. A central role of neuroinflammation has emerged, with evidence of activation of the innate and adaptive immunity, dysregulation of microglial and astrocytic activity and production of multiple cytokines and other inflammatory mediators.
A case of visual impairment due to HHV-6 encephalitis after allogeneic hematopoietic stem cell transplantation in childhood acute myeloid leukemia-M2 subtype.
Ann Hematol
December 2024
Department of Pediatrics (Children Hematological Oncology), Childhood Hematological Oncology and Birth Defects Laboratory, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China.
Article Synopsis
- * Human herpesvirus 6 (HHV-6) encephalitis is a rare but serious complication post-transplant, leading to high fatality rates among patients.
- * A case study describes a child with AML who developed visual impairment from HHV-6B encephalitis during allo-HSCT, highlighting the need for better diagnosis and treatment strategies for this condition.
Symptomatic central nervous system tuberculosis and human herpesvirus-6 coinfection with associated hydrocephalus managed with endoscopic third ventriculostomy: A case report and review of human herpesvirus-6 neuropathology.
Surg Neurol Int
August 2024
Division of Pediatric Neurosurgery, Children's Hospital Orange County, Orange, California, United States.
Article Synopsis
- Human herpesvirus 6 (HHV-6) is a common childhood virus that usually causes mild febrile illness but has been linked to more severe conditions like meningoencephalitis in some cases, particularly in those with weakened immune systems.
- A case study details the treatment of an 18-month-old girl who presented with symptoms suggesting meningitis, leading to a diagnosis of HHV-6 after extensive testing and amid concerns for CNS tuberculosis.
- Initially considered incidental, the initiation of antiviral therapy coincided with the child’s clinical improvement, suggesting HHV-6 may have played a more significant role in her condition than previously thought.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!