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Herpes encephalitis in children. MRI assessment
H Cakmakçi1, A Kovanlikaya, F Obuz
1Department of Radiology, Dokuz Eylül University Faculty of Medicine, Izmir.
Abstract:
The magnetic resonance imaging (MRI) findings in 14 patients with biopsy or polymerase chain reaction proven herpes simplex encephalitis were retrospectively reviewed to evaluate the diagnostic value of MRI in the early diagnosis of herpes simplex encephalitis in children. In addition to the early findings, follow-up MRI scans were obtained in four patients. Typical limbic system involvement was seen in 78 percent of the cases. Contrast-enhanced MRI was found to be superior to routine MRI sequences and computerized tomography (CT) in the early detection of inflammation. Follow-up MR images in four patients demonstrated the volume loss and late petechial hemorrhage in the involved regions. Magnetic resonance imaging is the method of choice in the diagnosis and follow-up of herpes simplex encephalitis.
Insights
Magnetic resonance imaging (MRI) is crucial for early herpes simplex encephalitis diagnosis in children. Contrast-enhanced MRI offers superior inflammation detection compared to CT scans.
Area of Science:
- Neurology
- Radiology
- Pediatrics
Background:
- Herpes simplex encephalitis (HSE) is a severe neurological condition.
- Early diagnosis is critical for effective treatment and improved outcomes in children.
Purpose of the Study:
- To evaluate the diagnostic value of MRI in the early detection of HSE in pediatric patients.
- To compare MRI findings with biopsy or PCR-proven HSE diagnoses.
Main Methods:
- Retrospective review of MRI findings in 14 children with confirmed HSE.
- Analysis of both routine and contrast-enhanced MRI sequences.
- Comparison with computerized tomography (CT) scans.
Main Results:
- Typical limbic system involvement observed in 78% of cases.
- Contrast-enhanced MRI demonstrated superior early inflammation detection over routine MRI and CT.
- Follow-up MRI revealed volume loss and petechial hemorrhage in affected areas.
Conclusions:
- MRI is the preferred imaging modality for diagnosing and monitoring HSE in children.
- Contrast-enhanced MRI significantly aids in early HSE detection.
- MRI findings correlate with disease progression, including volume loss and hemorrhage.