Parainfectious encephalomyeloradiculitis associated with herpes simplex virus 1 DNA in cerebrospinal fluid.
We describe a patient with acute encephalomyeloradiculitis associated with herpes simplex virus 1 (HSV-1) DNA in the cerebrospinal fluid (CSF), and we also review 4 similar cases previously reported from Japan. A 59-year-old man presented with acute encephalitis and urinary retention. Initially, coma and CSF pleocytosis improved with acyclovir treatment, but brain stem encephalitis, transverse myelitis, and lumbosacral polyradiculitis subsequently occurred. These conditions responded to corticosteroid therapy and immunoadsorption plasmapheresis. Polymerase chain reaction detected HSV-1 DNA in the CSF during acute encephalitis but not thereafter. Serial magnetic resonance imaging revealed transient lesions in the thalamus and basal ganglia on both sides of the brain and in the pons, spinal cord, and cauda equina. Acute encephalomyeloradiculitis is a unique neurological syndrome that may be caused by HSV-1 infection of the central nervous system.
Kusuhara
T
T
Department of Neurology, School of Medicine, Fukuoka University, Fukuoka, Japan 814-0180.
Nakajima
M
M
Inoue
H
H
Takahashi
M
M
Yamada
T
T
D002493:Central Nervous System Diseases / Q000150:complications* / Q000821:virology; D004279:DNA, Viral / Q000134:cerebrospinal fluid*; D004660:Encephalitis / Q000134:cerebrospinal fluid / Q000150:complications / Q000276:immunology / Q000821:virology*; D006561:Herpes Simplex / Q000134:cerebrospinal fluid / Q000150:complications / Q000276:immunology / Q000821:virology*; D018259:Herpesvirus 1, Human / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction
D004279:DNA, Viral