Progression of MRI abnormalities in herpes simplex encephalitis despite clinical improvement: natural history or disease progression?
Progression of MRI abnormalities in herpes simplex encephalitis despite clinical improvement: natural history or disease progression?
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DOI：
10.1007/s10072-004-0240-5
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发表时间：
2004-06-01
影响因子：
3.3
通讯作者：
Monaco, F
中科院分区：
文献类型：
--
作者：
Gaviani, P;Leone, M;Monaco, F
单纯疱疹病毒脑炎（HSVE）具有高死亡率和高概率的神经系统后遗症。及时诊断 HSVE 并用阿昔洛韦治疗可取得良好效果。我们介绍了一名临床诊断为 HSVE 的 71 岁女性，通过 PCR 检测脑脊液中的 HSV-1 DNA 确诊。她接受阿昔洛韦（每天 30 毫克/公斤）治疗两周。入院后 6 个月的临床和神经心理学评估均正常；然而，2、6 和 12 个月时的 MRI 显示进行性恶化，伴有广泛的白质和皮质损伤。需要对 PCR 确诊的 HSVE 幸存患者队列进行影像学研究，以确定这种模式是偶然的还是频繁的进展形式。
Herpes simplex virus encephalitis (HSVE) is associated with a high mortality rate and a high probability of neurological sequelae. Good results are obtained when HSVE is promptly diagnosed and treated with acyclovir. We present a 71-year-old woman with clinically diagnosed HSVE, confirmed by PCR detection of HSV-1 DNA in the cerebrospinal fluid. She was treated with acyclovir (30 mg/kg day) for two weeks. Clinical and neuropsychological assessments 6 months after admission were normal; however MRI at 2, 6 and 12 months showed progressive deterioration with extensive white matter and cortical damage. Imaging studies of a cohort of patients surviving PCR-confirmed HSVE are needed to determine whether this pattern is occasional or a frequent form of progression.