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Encephalitis ll: Pathophysiology

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Encephalitis is inflammation of the brain parenchyma caused by direct viral invasion or immune-mediated mechanisms triggered by infections or tumors. Both processes lead to neuronal injury, disrupted neurotransmission, and diverse neurological symptoms, often with overlapping clinical and pathological features.Autoimmune EncephalitisIn autoimmune encephalitis, antibodies target neuronal antigens on cell surfaces, synapses, or within neurons. A key example is anti-NMDAR encephalitis, which can...

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Bacterial Meningitis II: Pathophysiology

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Viral Meningitis

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Related Experiment Video

Updated: Jul 13, 2026

Intracerebroventricular and Intravascular Injection of Viral Particles and Fluorescent Microbeads into the Neonatal Brain

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Published on: July 24, 2016

Brainstem involvement in neonatal herpes simplex virus type 2 encephalitis.

Gustavo Pelligra¹, Niamh Lynch, Steven P Miller

¹Division of Neonatology, Children's and Women's Health Centre of British Columbia, 4480 Oak St, Vancouver, British Columbia, Canada V6H 3V4.

|August 3, 2007

Summary

Herpes simplex virus type 2 rarely affects the brainstem in newborns. This case study details a neonate with significant brainstem and cerebellar damage from HSV-2 encephalitis, highlighting early MRI detection.

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Area of Science:

Neuroscience
Infectious Diseases
Pediatric Neurology

Background:

Neonatal herpes simplex virus encephalitis (HSVE) typically presents with widespread cerebral cortex involvement.
Herpes simplex virus type 2 (HSV-2) is an uncommon cause of HSVE and rarely involves the brainstem.

Observation:

A 16-day-old infant presented with symptoms suggestive of central nervous system infection.
Initial diffusion-weighted magnetic resonance imaging (MRI) revealed restricted diffusion predominantly in the brainstem and cerebellum.
Conventional MRI sequences did not show abnormalities at the initial stage.

Findings:

The infant was diagnosed with herpes simplex virus type 2 encephalitis.
The pattern of involvement was predominantly in the brainstem and cerebellum, which is atypical for neonatal HSVE.
Serial MRI demonstrated injury progression along the corticospinal tracts without supratentorial gray or white matter damage.

Implications:

This case represents the first reported instance of predominant brainstem involvement in neonatal HSV-2 encephalitis.
Diffusion-weighted MRI is crucial for early detection of central nervous system involvement in neonatal encephalitis.
Serial MRI scans are important for monitoring the evolution of brain lesions in neonatal HSVE.