Morphological and ultrastructural changes in Herpes simplex encephalomyelitis: an attempt to determinate the
Teresa Wierzba-Bobrowicz1, Eliza Lewandowska1, Paulina Felczak1
1Department of Neuropathology, Institute of Psychiatry and Neurology, Warsaw, Poland.
Folia Neuropathologica
|July 31, 2020
Summary
Diagnosing Herpes simplex encephalomyelitis (HSE) is challenging. Morphological and ultrastructural examinations of brain and spinal cord tissue offer a valuable method for accurate diagnosis and identifying the specific viral cause.
Area of Science:
- Neurology
- Virology
- Pathology
Background:
- Herpes simplex encephalomyelitis (HSE) is a rare, high-mortality neurological disease.
- Accurate diagnosis of HSE is often hindered by clinical similarities and inconclusive standard diagnostic tests.
Observation:
- Two cases of HSE were analyzed, one with acute encephalitis and another with subacute encephalomyelitis.
- Both patients presented with negative serological and molecular results for Herpes simplex in blood and cerebrospinal fluid.
- Histological, immunohistochemical, and transmission electron microscopy (TEM) were performed on brain and spinal cord samples.
Findings:
- Microscopic examination confirmed viral encephalomyelitis in both cases.
- Electron micrographs revealed typical intranuclear viral particles within damaged neurons.
- Findings suggest possible involvement of Human Herpesvirus 1/2 (HHV-1/HHV-2) in the first case and Human Herpesvirus 3 (HHV-3) in the second.
Implications:
- Morphological and ultrastructural examinations serve as crucial diagnostic tools for viral encephalomyelitis.
- These methods can aid in identifying the specific causative viral agent when conventional tests are inconclusive.
- This approach enhances diagnostic accuracy for rare and severe neurological infections.
