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[Imaging in pediatric Herpes simplex virus type I encephalitis]
S Panisset1, C Adamsbaum, B Heron
1Service de Radiologie, Hôpital Saint Vincent de Paul, Paris.
Insights
Radiological features of herpes simplex virus 1 encephalitis in children are described. Hemorrhagic lesions and unilateral thalamic involvement appear after 4 days, correlating with clinical recurrence.
Area of Science:
- Pediatric Neurology
- Neuroradiology
- Infectious Diseases
Background:
- Herpes simplex virus 1 encephalitis (HSVE) is a rare but severe neurological infection.
- Radiological findings in pediatric HSVE are not well-documented, particularly in early disease stages.
Purpose of the Study:
- To characterize the spectrum of radiological findings in children diagnosed with herpes simplex virus 1 encephalitis.
- To correlate imaging findings with disease progression and clinical presentation.
Main Methods:
- Retrospective analysis of imaging studies (CT and MRI) in 10 children with confirmed HSVE.
- Evaluation of imaging findings in relation to the timing of clinical presentation and disease course.
Main Results:
- Initial CT scans were normal in 50% of cases; low densities and hemorrhagic lesions were present in nearly 50%.
- Hemorrhagic lesions were observed in all patients after 4 days of infection.
- Unilateral thalamic involvement was noted in 50% of cases, associated with clinical recurrence.
Conclusions:
- Early CT scans may not reveal abnormalities in pediatric HSVE.
- Hemorrhagic lesions and thalamic involvement are significant findings in later stages of HSVE.
- The clinical significance of thalamic involvement in HSVE requires further investigation.
Purpose:
The aim of this study was to describe radiological features of herpes simplex virus 1 encephalitis, rarely reported in children.
Patients And Methods:
We analyzed imaging findings in 10 children with biologically proven herpes simples virus 1 encephalitis.
Results:
Eight CT scans were performed before the second day of the clinical course, 6 CT and 6 MRI were performed after day 4. The initial CT scan was normal in half of the cases. Low densities and hemorrhagic lesions were seen in almost half of the cases. There was no abnormal contrast enhancement in this series.
Discussion:
After 4 days of infection, hemorrhagic lesions were seen in all cases. Unilateral thalamic involvement was observed in half of the children, in correlation with clinical recurrence of encephalitis. The diagnostic, histological and therapeutic significance of these thalamic involvements remains to be elucidated.