Corticosteroid-responsive focal granulomatous herpes simplex type-1 encephalitis in adults

  title={Corticosteroid-responsive focal granulomatous herpes simplex type-1 encephalitis in adults},
  author={Aravinthan Varatharaj and James A R Nicoll and Emanuela Pelosi and Ashwin Arnold Pinto},
  journal={Practical Neurology},
  pages={140 - 144}
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… 
An Adult Case of Herpes Simplex Virus-associated Granulomatous Encephalitis
A 74-year-old man with a history of herpes simplex encephalitis suffered recurrent seizures and brain magnetic resonance imaging revealed a mass lesion and resection was performed, and a polymerase chain reaction using a brain biopsy specimen was positive for HSV DNA; thus, the patient was diagnosed with HSV-associated granulomatousEncephalitis.
A rare suspected case of chronic nodular granulomatous herpes simplex encephalitis in an adult
To the author’s knowledge, this is the first reported case of macroscopic “mass-like” nodular granuloma formation in an adult.
Potential Role for Herpesviruses in Alzheimer's Disease.
Consideration reveals a possible viral "Hit-and-Run" scenario of AD, as well as neurobiological mechanisms that may increase risk for AD following neurotropic infection, and reveals several novel therapeutic targets that may prove efficacious in AD.


Chronic Granulomatous Herpes Simplex Encephalitis in Children
It is indicated that herpes simplex encephalitis in children can be complicated by chronic granulomatous inflammation with mineralization, which may be an under-recognized complication of herpessimplex infection during the first few years of life.
Relapsing herpes simplex encephalitis: pathological confirmation of viral reactivation
Clinical and pathological findings suggest that direct viral reactivation might result in a relapse of herpes simplex encephalitis, causing progressive clinical deterioration associated with the persistence of HSV-1 in the brain.
Herpes simplex virus–1 encephalitis can trigger anti-NMDA receptor encephalitis: Case report
An adult with this disorder is reported, it is demonstrated that synthesis of NMDAR antibodies began after HSVE, and relapsing symptoms were due to steroid-responsive anti-NMDAR encephalitis.
Autopsy neuropathological findings in ‘burnt out’ herpes simplex encephalitis and use of the polymerase chain reaction to detect viral DNA
The hypothesis that herpes simplex virus may persist within the central nervous system after acute herpes encephalitis, to cause latent or low‐grade productive infection, is supported.
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Management of herpes simplex encephalitis has been considerably improved by the availability of acyclovir therapy and rapid polymerase chain reaction (PCR)-based diagnostic assays, but prognosis for patients with HSE is misestimated.
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A group of clinicians met in Liverpool in February 2008 to begin the development process for clinical care guidelines based around a similar simple algorithm, supported by an evidence base, whose implementation is hoped would improve the management of patients with suspected encephalitis.
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The results do not rule out the possibility that EBV is involved in the pathogenesis of MS by triggering diverse cellular immune mechanisms, but they argue against a direct pathogenic role of EBV-targeted humoral immune response within the CNS.
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An immunoperoxidase technique was used to map the sites of herpes simplex virus antigen (VA) within the brain in 29 autopsied cases of herpessimplex encephalitis, and attention is drawn to focally extensive infection of the granule cell of the dentate fascia.
Diagnosis of herpes simplex encephalitis: application of polymerase chain reaction to cerebrospinal fluid from brain-biopsied patients and correlation with disease. National Institute of Allergy and Infectious Diseases Collaborative Antiviral Study Group.
HSV DNA was detected by polymerase chain reaction (PCR) in CSF of 53 (98%) of 54 patients with biopsy-proven HSE and was detected in all 18 CSF specimens obtained before brain biopsy from patients with proven HSE.
Herpes simplex virus genomes in human nervous system tissue analyzed by polymerase chain reaction
The study has confirmed the previous demonstration of latent HSV in trigeminal ganglia in normal humans and assessed the frequency and distribution of HSV genomes in the nervous system tissues of patients dying of nonneurological causes.