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Updated: May 5, 2026

A Primary Neuron Culture System for the Study of Herpes Simplex Virus Latency and Reactivation
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Asymptomatic self-limiting diffuse white matter lesions in subacute to chronic stage of herpes simplex encephalitis

A M Tokumaru1, K Kamakura, H Terada

  • 1Department of Radiology, Tokyo Metropolitan Medical Center of Gerontology; Tokyo, Japan - tokumaru@tmgh.metro.tokyo.jp.

The Neuroradiology Journal
|November 22, 2013
PubMed

Insights

Herpes simplex encephalitis (HSE) frequently causes white matter changes in the subacute stage. These changes often resolve within two years, suggesting potential immune-mediated processes.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Radiology

Background:

  • Herpes simplex encephalitis (HSE) is a severe neurological infection.
  • White matter involvement in HSE is not fully understood.
  • Longitudinal imaging is crucial for assessing HSE progression.

Purpose of the Study:

  • To evaluate white matter changes in subacute and chronic HSE.
  • To correlate imaging findings with clinical and laboratory data.
  • To understand the natural course of white matter abnormalities in HSE.

Main Methods:

  • 15 patients with HSE underwent serial MRI scans.
  • Scans were performed at onset, 7-10 days, 3-5 weeks, 2-3 months, 6 months, and <1 year post-onset.
  • Cerebrospinal fluid (CSF) analysis and clinical data were collected.

Main Results:

  • Diffuse white matter signal abnormalities were observed in 40% (6/15) of patients during the subacute stage (3-5 weeks).
  • No significant correlation found between white matter changes and lab data, acyclovir dose, or symptoms.
  • Abnormalities resolved or improved by two years, irrespective of treatment.

Conclusions:

  • Diffuse white matter signal abnormalities are common in the subacute phase of HSE.
  • The exact cause of these lesions remains unclear, possibly involving immune-mediated mechanisms.
  • Long-term MRI monitoring is essential for managing HSE patients.

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