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MRI deterioration in herpes simplex encephalitis despite clinical recovery
Sofia Markoula1, Sotirios Giannopoulos, Sigliti-Henrietta Pelidou
1Departments of Neurology, University of Ioannina, Greece. me01415@cc.uoi.gr
The Neurologist
|July 11, 2009
Summary
Herpes simplex encephalitis patients may show MRI changes suggesting relapse even after recovery. These imaging findings do not always indicate a true relapse, especially when clinical and CSF results are normal.
Area of Science:
- Neurology
- Infectious Diseases
- Radiology
Background:
- Herpes simplex virus type 1 (HSV-1) is a rare but serious cause of viral encephalitis.
- Relapse of HSV-1 encephalitis occurs in up to 10% of cases, marked by recurrent symptoms and diagnostic findings.
Observation:
- This study details two patients with HSV-1 encephalitis, focusing on clinical features, MRI, and outcomes.
- Follow-up at six months revealed MRI lesions indicative of recurrence despite clinical recovery and normal CSF.
Findings:
- Both patients demonstrated a positive response to treatment and achieved excellent clinical recovery.
- Despite clinical improvement, follow-up MRIs showed lesions consistent with recurrence, without concurrent clinical or CSF abnormalities.
Implications:
- The mechanism behind post-encephalitis MRI deterioration is uncertain, possibly involving immune-mediated processes.
- MRI findings suggestive of recurrence after HSV-1 encephalitis warrant cautious interpretation, as they may not represent true relapse if clinical and CSF data are negative.
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