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Detection of the Genome and Transcripts of a Persistent DNA Virus in Neuronal Tissues by Fluorescent In situ Hybridization Combined with Immunostaining

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Symmetrical brainstem encephalitis caused by herpes simplex virus.

Shiroh Miura¹, Takashi Kurita, Kazuhito Noda

¹Division of Respirology, Neurology and Rheumatology, Department of Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830-0011, Japan. shiroh46@med.kurume-u.ac.jp

Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia

|February 10, 2009

Summary

A herpes simplex virus (HSV) brainstem encephalitis case in a 53-year-old man showed unique symmetrical lesions. Advanced MRI techniques revealed vasogenic edema, offering new insights into HSV encephalitis.

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Area of Science:

Neurology
Infectious Diseases
Radiology

Background:

Herpes simplex virus (HSV) encephalitis is a severe neurological condition.
Brainstem involvement is rare and challenging to diagnose.
Standard diagnostic methods include cerebrospinal fluid analysis and neuroimaging.

Observation:

A 53-year-old male presented with symptoms suggestive of brainstem encephalitis.
Cerebrospinal fluid analysis confirmed the presence of HSV immunoglobulin M antibodies.
Magnetic Resonance Imaging (MRI) revealed unique symmetrical lesions in the brainstem.

Findings:

The symmetrical lesions were potentially linked to trigeminal nerve HSV reactivation.
Diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) mapping were utilized.
These advanced MRI techniques indicated vasogenic edema as the cause of the lesions.

Implications:

This case highlights the utility of advanced MRI in diagnosing HSV brainstem encephalitis.
Understanding lesion characteristics can improve early detection and treatment strategies.
The findings contribute to the knowledge of HSV pathogenesis in the central nervous system.