Abstract
Involvement of the CNS due to viral infection has tremendous importance because of the potential for death and neurologic damage. These viruses display tissue tropism and cause illness with a characteristic temporal course. Viral infections of the CNS may present as meningitis, encephalitis, meningoencephalitis, or meningoencephalomyelitis or myelitis with or without radiculitis. Depending on the duration of the illness, it is labeled as acute (days) or chronic when it evolves over weeks. Another way to classify viral infection of the CNS is based on the pathogenesis. The encephalitis that results from direct viral entry into the CNS is referred to as primary encephalitis. However, subsequent damage may occur as a consequence of host immune response, but invasion by the pathogen initiates the CNS damage. An encephalitis temporally associated with a systemic viral infection without evidence of direct viral invasion in the CNS is referred to as postinfectious or parainfectious encephalitis (1). Primary encephalitis will be discussed in the present chapter and parainfectious encephalitis and HIV encephalitis will be discussed separately in later chapters.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Johnson RT. The pathogenesis of acute viral encephalitis and postinfectious encephalomyelitis. J Infect Dis 1987; 155: 359–364.
Cassady KA, Whitley RJ. Pathogenesis and pathophysiology of viral infections of the central nervous system. In Infections of the central nervous system ,WM Scheid, RJ Whitley, DT Durack, eds. Philadelphia: Lippincott-Raven, 1997; 7–23.
Boos J, Kim JH. Biopsy histopathology in herpes simplex encephalitis and in encephalitis of undefined etiology. Yale J Biol Med 1984; 57: 751–755.
Gracia JH, Colon LE, Whitley RJ, et al. Diagnosis of viral encephalitis by brain biopsy. Semin Diagn Pathol 1984; 1: 1334–1342.
Gressens P, Langston C, Martin JR. In situ PCR localization of herpes simplex virus DNA sequences in disseminated herpes encephalitis. J Neuropathol Exp Neurol 1994; 53: 469–482.
Lakeman FD, Whitley RJ. Diagnosis of herpes simplex encephalitis: Application of polymerase chain reaction to cerebrospinal fluid from brain-biopsied patients and correlation with disease. J Infect Dis 1995; 171: 857–873.
Demaerel P, Wilms G, Robberecht, et al. MRI and herpes simplex encephalitis. Neuroradiology 1992; 32: 490–493.
Schmidbauer M, Podreka I, Wimberger D, et al. SPECT and MR imaging in herpes simplex encephalitis. J Comput Assist Tomogr 1991; 15: 811–815.
Schroth G, Gawehn J, Thron A, Vallbracht A, Voigt K. Early diagnosis of herpes simplex encephalitis by MRI. Neurology 1987; 37: 179–183.
Tien RD, Felsberg GJ, Osumi AK. Herpesvirus infections of the CNS: MR findings. Am J Roentgenol 1993; 161:167–176.
Tsuchiya K, Inaoka S, Mizutani Y, Hachiya J. Fast fluid-attenuated inversion recovery MR of intracranial infections. Am J Neuroradiol 1997; 18: 909–913.
Burke JW, Mathews VP, Elster AD, Ulmer JL, McLean M, Davis SE. Contrast enhanced magnetization transfer saturation imaging improves MR detection of herpes simplex encephalitis. Am J Neuroradiol 1996; 17: 773–776.
Domingues RB, Fink MCD, Tsanaclis AMC, et al. Diagnosis of herpes simplex encephalitis by magnetic resonance imaging and polymerase chain reaction assay of cerebrospinal fluid. J Neurol Sci 1998; 157: 148-153.
Lester JW, Carter MP, Reynolds TL. Herpes encephalitis: MR monitoring of response to acyclovir therapy. J Comput Assist Tomogr 1988; 12: 941–943.
Koelfen W, Freund M, Guckel F, Rohr H, Schultze C. MRI of encephalitis in children: Comparison of CT and MRI in the acute stage with long-term follow-up. Neuroradiology 1996; 38: 73–79.
Jay V, Hwang P, Hoffman HJ, Becker LE, Zielenska M. Intractable seizure disorder associated with chronic herpes infection. Child’s Nerv Syst 1998; 14: 15–20.
Hitosugi M, Ichijo M, Matsuoka Y, Takenaka N, Fujii H. Proton MR spectroscopy findings in herpes simplex encephalitis. Clin Neurol 1996; 36: 839–843.
Menon DK, Sargentoni J, Peden CJ, et al. Proton MR spectroscopy in herpes simplex encephalitis: Assessment of neuronal loss. J Comput Assist Tomogr 1990; 14: 449–452.
Takanashi J, Sugita K, Ishii M, Aoyagi M, Niimi H. Longitudinal MR imaging and proton MR spectroscopy in herpes simplex encephalitis. J Neurol Sci 1997; 149: 99–102.
Sakakibara R, Hattori T, Fukutake T, Mori M, Yamanishi T, Yasuda K. Micturational disturbance in herpetic brainstem encephalitis; contribution of the pontine micturition center. J Neurol Neurosurg Psychiatry 1998; 64:269–272.
Lentz D, Jordan JE, Pike GB, Enzmann DR. MRI in varicella-zoster virus leukoencephalitis in the immunocompromised host. J Comput Assist Tomogr 1993; 17: 313–316.
Gilden DH, Murray RS, Wellish M, Keinschmidt-Demasters BK, Vafai A. Chronic progressive varicella zoster virus encephalitis in an AIDS patient. Neurology 1988; 38: 1150–1153.
Lipton SA, Schaeffer PW, Ma MJ. Case records of the Massachusetts General Hospital. N Engl J Med 1996; 335: 1587–1595.
Weaver S, Rosenblum MK, DeAngelis LM. Herpes varicella zoster encephalitis in immunocompromised patients. Neurology 1999; 52: 193–195.
McCullers JA, Lakeman FD, Whitley RJ. Human herpesvirus 6 is associated with focal encephalitis. Clin Infect Dis 1995; 21: 571–576.
Mookerjee BP, Vogelsang G. Human herpesvirus 6 encephalitis after bone marrow transplantation: Successful treatment with ganciclovir. Bone Marrow Transplant 1997; 20: 905–906.
Bosi A, Zazzi M, Amantini A, et al. Fatal herpesvirus 6 encephalitis after unrelated bone marrow transplant. Bone Marrow Transplant 1998; 22: 285–288.
Morgello S, Cho ES, Nielsen S, Devinsky O, Petito CK. Cytomegalovirus encephalitis in patients with acquired immunodeficiency syndrome: An autopsy study of 30 cases and a review of literature. Hum Pathol 1987; 18: 289–297.
Huang PP, McMeeking AA, Stempien MJ, Zagzag D. Cytomegalovirus disease presenting as a focal brain mass: Report of two cases. Neurosurgery 1997; 40: 1074–1079.
Silversides JL, Richardson JC. Neurological complications of infectious mononucleosis. Can Med Assoc J 1950;63: 138–143.
Ross JP, Cohen JI. Epstein-Barr virus. In Infections of the central nervous system ,WM Scheid, RJ Whitley, DT Durack, eds. Philadelphia: Lippincott-Raven, 1997; 117–127.
Ito H, Sayama S, Irie S, et al. Antineuronal antibodies in acute cerebellar ataxia following Epstein-Barr virus infection. Neurology 1994; 44: 1506–1507.
Kou K, Itoh M, Kawano Y. A case report of EB virus-induced meningoencephalitis associated with brain MRI abnormalities (basal ganglia). J Jpn Pediatr Soc 1994; 98: 2052–2059.
Shouji H, Kusuhara T, Honda H. Relapsing acute disseminated encephalomyelitis associated with chronic Epstein-Barr virus infection: MRI findings. Neuroradiology 1992; 34: 340–342.
Ono J, Shimizu K, Harada K, Mano T, Okada S. Characteristic MR features of encephalitis caused by Epstein-Barr virus: A case report. Pediatr Radiol 1998; 28: 569–570.
TsaiTF. Arboviral infections in the United States. Infect Dis Clin North Am 1991; 5: 73–103.
Piliero PJ, Brody J, Zamani A, Deresiewicz RL. Eastern equine encephalitis presenting as focal neuroradiographic abnormalities: Case report and review. Clin Infect Dis 1994; 18: 985–988.
Morse RP, Bennish ML, Darras BT. Eastern equine encephalitis presenting with a focal brain lesion. Pediatr Neurol 1992; 8: 473–475.
Faber S, Hill A, Connery ML, Dingle JH. Encephalitis in infants and children caused by the virus of the eastern variety of equine encephalitis. J Am Med Assoc 1940; 114: 1725–1731.
Dent JH. Pathological changes in the brains of children infected with the virus of eastern equine encephalomyelitis. Bull Tulane Med Fac 1955; 14: 85–96.
Hauser GH. Human equine encephalomyelitis, eastern type, in Louisiana. New Orleans Med Surg J 1948; 100:551–558.
Deresiewicz RL, Thaler SJ, Hsu L, Zamani AA. Clinical and neuroradiographic manifestations of eastern equine encephalitis. N Engl J Med 1997; 336: 1867–1874.
Misra UK, Kalita J, Jain SK, Mathur A. A study of radiological and neurophysiological changes in Japanese encephalitis. J Neurol Neurosurg Psychiatry 1994; 57: 1484–1487.
Shoji H, Murakami T, Murai I, Kida H, Sato Y, Kojima K, Abe T, Okudera T. Follow-up study by CT and MRI in three cases of Japanese encephalitis. Neuroradiology 1990; 32: 215–219.
Shoji H, Hiraki U, Kuwasaki N, Toyomasu T, Kaji M, Okudera T. Japanese encephalitis in the Kurume region of Japan: CT and MRI findings. J Neurol 1989; 236: 255–259.
Kumar S, Misra UK, Kalita J, Sawlani V, Gupta RK, Gujral R. MRI in Japanese encephalitis. Neuroradiology 1997; 39: 180–184.
Zimmerman HM. The pathology of Japanese B encephalitis. Am J Pathol 1946; 22: 965–991.
Deasi A, Shanker SK, Ravi V, Chandramuki A, Gauridevi M. Japanese encephalitis virus antigen in human brain and its topographic distribution. Acta Neuropathol 1995; 89: 368–373.
Ishii K. Virological and serological diagnosis of Japanese encephalitis. Adv Neurol Sci 1967; 11: 300–311.
Pradhan S, Pandey N, Yadav S, Gupta RK, Mathur A. Parkinsonism due to predominant involvement of substantia nigra in Japanese encephalitis. Neurology 1999, 53: 1781–1786.
Cerna F, Mehrad B, Luby JP, Burns D, Fleckenstein JL. St. Louis encephalitis and substantia nigra: MR imaging evaluation. Am J Neuroradiol 1999; 20: 1281–1283.
Kipps A, Dick G, Moodie JW. Measles and the central nervous system. Lancet 1983; 2: 1406–1410.
Pearl PL, Abu Farsakh H, Starke JR, Drever Z, Louis PT, Kirkpatrick JR. Neuropathology of two fatal cases of measles in 1988–89 Houston epidemic. Pediatr Neurol 1990; 6: 126–130.
Dyken PR. Subacute sclerosing panencephalitis: Status. Neurol Clin 1985; 3: 179–196.
Haddad FS, Risk WS, Jabbour JT. Subacute sclerosing panencephalitis in the Middle East: Report of 99 cases. Ann Neurol 1977; 1: 211–217.
Case records of the Massachusetts General Hospital: Weekly clinicopathological exercises. N Engl J Med 1986; 314: 1689–1700. Case 25–1986.
Cattaneo R, Schmid A, Rebmann G, et al. Accumulated measles virus mutations in a case of subacute sclerosing panencephalitis: Interrupted matrix protein reading frame and transcription alteration. Virology 1986; 154: 97–107.
Risk WS, Haddad FS. The variable natural history of subacute sclerosing panencephalitis: A study of 118 cases from the Middle East. Arch Neurol 1979; 36: 610–614.
Chao D. Subacute inclusion body encephalitis: Report of 3 cases. J Pediatr 1962; 61: 501–510.
Gascon G, Yamani S, Crowell J, et al. Combined oral isoprinosine intraventricular alpha interferon therapy for subacute sclerosing panencephalitis. Brain Dev (Tokyo) 1993; 15: 346–355.
Yalaz K, Anlar B, Oktem F, et al. Intraventricular interferon and oral inosiplex in the treatment of subacute sclerosing panencephalitis. Neurology 1992; 42: 488–491.
Ohya T, Martinez AJ, Jabbour JT, Lemmi H, Duenas DA. Subacute sclerosing panencephalitis: Correlation of clinical, neurophysiologic and neuropathologic findings. Neurology 1974; 24: 211–218.
Lum GB, Williams JP, Dyken PR, et al. Magnetic resonance and CT imaging correlated with clinical status in SSPE. Pediatr Neurol 1986; 2: 75–79.
Takemoto K, Koizumi Y, Kogame S, et al. Magnetic resonance imaging of subacute sclerosing encephalitis. Jpn J Clin Radiol 1986; 31: 999–1004.
Murata R, Matsuoka O, Nakajimas S, et al. Serial magnetic resonance imaging in subacute sclerosing panencephalitis. Jpn J Psychiatr Neurol 1987; 41: 277–282.
Geller TJ, Vern BA, Sarwar M. Focal MRI findings in early SSPE. Pediatr Neurol 1987; 3: 310–312.
Tsuchiya K, Yamauchi T, Furui S. MR imaging vs CT in subacute sclerosing panencephalitis. Am J Neuroradiol 1988; 9: 943–946
Woodward KG, Weinberg PE, Lipton HL. Basal ganglia involvement in subacute sclerosing panencephalitis: CT and MR demonstration. J Comput Assist Tomogr 1988; 12: 489–491.
Dietrich RB, Vining EP, Taira RK, Hall TR, Phillpart M. Myelin disorders of childhood: Correlation of MR findings and severity of neurological impairment. J Comput Assist Tomogr 1990; 14: 693–698.
Winer JB, Pires M, Kermode A, Ginsberg L, Rossor M. Resolving MRI abnormalities with progression of subacute sclerosing panencephalitis. Neuroradiology 1991; 33: 178–180.
Brismar J, Generoso G, Steyern KV, Bohlega S. Subacute sclerosing panencephalitis: Evaluation with CT and MR. Am J Neuroradiol 1996; 17: 761–772.
Tuncay R, Akman-Demir G, Gokyigit A, et al. MRI in subacute sclerosing panencephalitis. Neuroradiology 1996; 38: 636–640.
Poon TP, Tchertkoff V, Win H. Subacute measles encephalitis with AIDS diagnosed by fine needle aspiration biopsy. Acta Cytol 1998; 42: 729–733.
Gazzola P, Cocito L, Capello E, Roccatagliata L, Canepa M, Mancardi GL. Subacute measles encephalitis in a young man with immunosuppressed for ankylosing spondylitis. Neurology 1999; 52:1074–1077.
Donohue WL, Playfair FD, Whitaker L. Mumps encephalitis: Pathology and pathogenesis. J Pediatr 1955; 47:395–412.
Tarr RW, Edwards KM, Kessler RM, Kulkarni MV. MRI of mumps encephalitis: Comparison with CT evaluation. Pediatr Radiol 1987; 17: 59–62.
Bodian D. Poliovirus in chimpanzee tissues after virus feeding. Am J Hyg 1956; 64: 187.
Bodian D. Histopathological basis of clinical findings in poliomyelitis. Am J Med 1949; 6: 563–578.
Hayward JC, Gillespie SM, Kaplan KM, et al. Outbreak of poliomyelitis like paralysis associated with enterovirus 71. Pediatr Infect Dis J 1989; 8: 611–616.
Wasserstrom R, Mamaorian AC, McGary CT, Miller B. Bulbar poliomyelitis: MRI findings with pathologic correlation. Am J Neuroradiol 1992; 13: 371–373.
Makamato M, Morimoto T, Nagao H, Matsuda H. MRI in poliomyelitis like syndrome. Pediatr Radiol 1992; 22: 533–534.
Kornreich L, Dagan M, Grunebaum M. MRI in acute poliomyelitis. Neuroradiology 1996; 38: 371–372.
PrusinerSB. Prions and neurodegenerative diseases. N Engl J Med 1987; 317:1571–1581.
Masters CL, Harris JO, Gajdusek DC, Gibbs CJ Jr, Bernoulli C, Asher DM. Creutzfeldt-Jakob disease: Patterns of worldwide occurrence and the significance of familial and sporadic clustering. Ann Neurol 1979; 5: 177–188.
Brown P, Cathala F, Castaigne P, Gajdusek DC. Creutzfeldt-Jakob disease: Clinical analysis of a consecutive series of 230 neuropathologically verified cases. Ann Neurol 1986; 20: 597–602.
Iwasaki Y, Ikeda K, Tagaya N, Kinoshita M. Magnetic resonance imaging and neuropathological findings in two patients with Creutzfeldt-Jakob disease. J Neurol Sci 1994; 126: 228–231.
Urbach H, Klisch J, Wolf HK, Gass S. MRI in sporadic Creutzfeldt-Jakob disease: Correlation with clinical and neuropathological data. Neuroradiology 1998; 40: 65–70.
De Priester JA, Jansen GH, de Kruijk JR. Wilmink JT. New MRI findings in Creutzfeldt -Jakob disease: High signal in the globus pallidus on T1-weighted images. Neuroradiology 1999; 41: 265–268.
Shyu WC, Lee C, Hsu Y, et al. Panencephalitic Creutzfeldt-Jakob disease: Unusual presentation of magnetic resonance imaging and proton magnetic resonance spectroscopy. J Neurol Sci 1996; 138: 157–160.
Demaerel P, Heiner L, Robberecht W, Sciot R, Wilms G. Diffusion-weighted MRI in sporadic Creutzfeldt Jakob disease. Neurology 1999; 52: 205–208.
Yee AS, Simon JH, Anderson CA, Sze CI, Filley CM. Diffusion weighted MRI of right hemisphere dysfunction in Creutzfeldt-Jakob disease. Neurology 1999; 52: 1514–1515.
Baren GB, Sowell MK, Sharp GB, Glasier CM. MR imaging in a child with Guillain-Barré syndrome. Am J Roentgenol 1993; 161: 161–163.
Victor M, Adams RD. Tropical spastic paraparesis and HTLVI infection. In Principles of neurology ,M Victor, RD Adams, eds. New York: McGraw-Hill, 1993; 1109.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2001 Kluwer Academic / Plenum Publishers
About this chapter
Cite this chapter
Gupta, R.K., Lufkin, R.B. (2001). Viral Infections. In: Gupta, R.K., Lufkin, R.B. (eds) MR Imaging and Spectroscopy of Central Nervous System Infection. Springer, Boston, MA. https://doi.org/10.1007/0-306-46844-1_4
Download citation
DOI: https://doi.org/10.1007/0-306-46844-1_4
Publisher Name: Springer, Boston, MA
Print ISBN: 978-1-4757-0573-7
Online ISBN: 978-0-306-46844-5
eBook Packages: Springer Book Archive