[Cytomegalovirus].
Since human cytomegalovirus (CMV) was discovered in 1950's the clinical pictures of CMV infection have been emphasized. During recent 30 years, the diagnosis and therapy of CMV infection have significantly progressed. Especially the diagnostic techniques developed from serum titers (complemental fixation) to PCR (polymerase chain reaction). Concerning the relation between CMV and neurological disorders of childhood, congenital CMV infection, classically called as cytomegalic inclusion disease, is still one of the most serious and important disorders, because the effective treatment and prophylactic method is not established. Most of symptomatic babies with congenital CMV infection disclose severe developmental handicap from infancy or expire during the neonatal period. In Japan, it is thought that 300-500 babies are born with symptoms of congenital CMV infection, annually. Infantile spasms (IS) is known as an intractable epilepsy with onset during infancy and its pathogenesis has been discussed for the relationship to CMV. Recently, Mashima (1992) discovered CMV-DNA from cerebrospinal fluid specimen of an IS baby, using PCR. This evidence strongly suggest the invasion of CMV to the central nervous system of the IS baby. In IS, adding to the pathogenetic problems, the ACTH therapy is frequently applied and it is known to accelerate the potential of CMV infection. Then, when treating IS babies having CMV infection, a closed observation and/or antiviral treatment shall be considered. In other epileptic disorders, Powers (1992) reported that CMV-DNA was discovered from 7 of 10 patients with Rasmussen syndrome. It is expected the role of CMV in various neurological disorders will be clarified, using newly developing techniques.
Toda Municipal Health Center, Saitama.
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Hiraiwa
D002648:Child; D003586:Cytomegalovirus Infections; D006801:Humans; D009422:Nervous System Diseases / Q000209:etiology