单纯疱疹病毒性脑炎的脑电图分析

探讨脑电图对单纯疱疹病毒性脑炎提供诊断依据和评价疾病严重程度,疗效和预后的意义。方法,对４２例ＨＳＥ的ＥＥＧ行回顾性分析,结果４２例中３７例ＥＥＧ异常,早期敏感性为８２％。结论ＨＳＥ之ＥＥＧ早期敏感性高,对诊断有指导作用,可作为推断本病严重程度及治疗效果的依据之一。     

急性单纯疱疹病毒性脑炎的护理

急性单纯疱疹病毒性脑炎的护理益艳文杨爱梅作者单位：１３００２１长春白求恩医大一院神经内科（益艳文），干部病房（杨爱梅）我院１９９５年１月至１９９６年１２月收治单纯疱疹脑炎患者１３例，现将临床病情观察及护理报告如下。１临床资料男８例，女５例。年龄１５～...     

单纯疱疹病毒性脑炎一例报告

单纯疱疹病毒性脑炎一例报告施福东，王维治，梁庆成，赵玉杰，孔秀香，刘杰民（哈尔滨医科大学附属第二医院神经科，哈尔滨１５００８６）患者女，２２岁，１９９３年７月２９日始发热（体温３８．６℃），伴有持续性头痛，且以双额部为主。于８月１日突然抽搐，并伴有意...     

单纯疱疹病毒性脑炎的MR诊断

单纯疤疫病毒性脑炎（HSE）是病毒性脑炎较多见的一种，临床病例不少见，但经MRI诊断者报告不多，笔者总结了我院经MRI诊断并经病毒学及临床证实的8例患者进行分析。临床资料本组8例病例中，男6例，女2例，年龄15～52岁，临床症状主要为发热，头痛．意识障碍，抽搐，精神症状及肢体活动障碍等．～人士现昏迷，临床查体发现颈强直，肌张力增高，已氏征（＋），患肢肌力减低（巨～1度），脑脊液除蛋白轻度增高外，余无异常发现，发病时间2天～2个月，其中3例行脑脊液病毒分离（PCR），2例分离出单纯疟疾病毒，余6例均呈典型的脑炎过程，…     

单纯疱疹病毒性脑炎脑脊液细胞学诊断

目的研究单纯疱疹病毒性脑炎（ＨＳＥ）之脑脊液细胞学。方法对４６例ＨＳＥ之脑脊液细胞学检查结果结合临床，作回顾性分析。结果本病脑脊液细胞学以淋巴样细胞反应为主，中性粒细胞反应仅见于短暂的急性期，亚急性与修复期并无明显界限，以起病后一周移行趋势较明显。早期发现脑脊液（ＣＳＦ）中红细胞是本病出血坏死的依据之一。结论脑脊液细胞学的改变，特别是动态观察，对本病的诊断有重要价值。     

单纯疱疹病毒性脑炎的早期诊断

单纯疱疹病毒性脑炎(HSE)是一种急性坏死性脑炎,由Ⅰ型或Ⅱ型单纯疱疹病毒(HSV)感染引起,死亡率高达70％,仅10％的病人可恢复正常生活能力。国外统计资料显示HSE约占全部脑炎的5％～20％,占已知病毒性脑炎的20％～68％。我国北京地区统计占“散发性脑炎”的18％。自从无环鸟苷应用于临床后,HSE的预后有了很大改善。研究认为无环鸟苷的疗效与用药早晚有很大关系,越早应用,疗效越好。因此     

单纯疱疹病毒性脑炎的临床和EEG研究

目的 :研究单纯疱疹病毒性脑炎 (HSE)的临床特点及脑电图 (EEG)的表现。方法 :对 2 5例HSE患者通过汇总分析发现临床与EEG的变化。结果 :HSE患者病前多有上感样症状 ,急性或亚急性起病 ,精神症状和癫痫发作为其主要表现。结论 :EEG在病程中有明显的变化特点     

单纯疱疹病毒性脑炎发病机制的研究进展

近年对单纯疱疹病毒性脑炎(HSE)。发病机制的研究发现,中枢神经系统存在的特异性病毒受体、病毒基因组的特定序列和编码的产物等决定了病毒的嗜神经性和神经毒力,免疫因素在HSE中起双重作用。机体免疫力降低可引起神经节内潜伏的病毒活化,免疫因素也参与了该过程。     

小鼠单纯疱疹病毒性脑炎主要免疫反应特性研究

目的 了解单纯疱疹病毒性脑炎(HSE)小鼠的主要免疫反应特性.方法 Balb/c小鼠颅内注射HSV1病毒制造HSE模型,脑组织切片观察病理变化,流式细胞仪检测CD11b、CD40、MHCⅠ、MHCⅡ抗原表达水平,RT-PCR检测脑内细胞因子(IL-2、IL-4、IL-10、TNF-α)mRNA表达水平.结果 HSE小鼠脑组织片状坏死出血.HSE小鼠表达CD11b、CD40、MHC 、MHC 增加,TH1型细胞因子(IL-2、TNF-α)、TH2型细胞因子(IL-4、IL-10)显著增高.结论 小胶质细胞感染后被激活、增殖,MHC增加以发挥抗原提呈作用;CD40表达将进一步激活小胶质细胞,促进TH1及TH2型细胞因子分泌.     

细胞因子IL-2、IL-10、TNF-α在小鼠单纯疱疹病毒性脑炎中的表达

目的检测细胞因子IL-2、IL-10、TNF-α在单纯疱疹病毒性脑炎(HSE)中的表达和变化,探讨细胞因子IL-2、IL-10、TNF-α在HSVE发病机制中的作用.方法使用逆转录-聚合酶链反应(RT-PCR)检测颅内感染单纯疱疹病毒1型(HSV1)的小鼠在感染后及使用无环鸟苷(ACV)治疗后细胞因子IL-2、IL-10、TNF-α变化及病理变化.结果HSV1感染后出现脑内出血坏死性的病理改变,IL-2、IL-10、TNF-α均明显上升;无环鸟苷治疗好转后脑内病理变化改善,IL-2保持稳定,IL-10继续上升,TNF-α显著下降.结论在小鼠HSVF急性期TH1型及TH2型反应同时被激活,发挥抗病毒作用,并以TH1型反应为主;在HSVE恢复期以TH2型反应为主,并抑制体内免疫反应的扩大;3种细胞因子的动态变化反映出机体免疫调节的动态平衡,并可反映HSVE的预后,早期应用ACV治疗HSVE确有极其明显的抗病毒治疗作用.     

Vascular and neuroglial changes in experimental herpes simplex encephalitis

Summary Generalized vascular changes and diffused proliferation of reactive microglia were observed in an experimental model of HSV encephalitis of mice. The wide spread of these changes contrasted with the localized character of virus replication and the confined areas of damaged nervous tissue. The vascular and microglial changes were precocious in animals inoculated with concentrated virus suspension (10^5.5LD₅₀) while they appeared late in mice inoculated with diluted virus suspension (100 LD₅₀). After inoculation with U.V. inactivated virus no changes were seen.The results obtained in this study suggest that the vascular and microglial modifications are not related to a direct cytopathic effect of the virus but dependent on the amount of virus present in the central nervous system and linked to the virus DNA.This work was supported by the Institut National de la Santé et de la Recherche Médicale (I.N.S.E.R.M.) and the Délégation Générale à la Recherche Scientifique et Technique (D.G.R.S.T.), Paris, France.     

Characteristic early electroencephalographic changes in herpes simplex encephalitis.

We review electroencephalograms taken from 17 patients with severe meningoencephalitis within seven days of onset of CNS symptoms and prior to cortical brain biopsies. All patients had CNS disease clinically compatible with the diagnosis of herpes simplex encephalitis (HSE). The diagnosis was demonstrated by the isolation of virus from the brain in five patients (group 1) but considered highly unlikely in the other 12 patients (group 2) by negative immunofluorescent studies and failure of viral isolation from the brain tissue. Abnormal but nonspecific EEGs with diffuse or focal slowing were found in all patients. Distinctive high-voltage, 1-cycle-per-2-to-3 seconds periodic sharp waves from unilateral temporal lobes were seen only in three of the five patients with virologically proved HSE but in none of the 12 patients without viral isolation. This EEG pattern is strikingly similar in all three patients, regardless of their age, and may be specific for the early diagnosis of HSE prior to brain biopsy. The EEGs of the other two patients with proved HSE did not contain such abnormalities. Athough periodic EEGs with some resemblance to those previously described may occur in other CNS disorders, their presence strongly suggests the diagnosis of HSE when recorded from patients with viral meningoencephalitis. Moreover, EEGs may help locate the best site for cerebral biopsy since maximal yield of the virus in this study was from unilateral temperoal lobes corresponding with the site of local EEG changes.     

Electroencephalography in herpes simplex encephalitis

The EEG in the acute stage of herpes simplex encephalitis (HSE) can show a variety of abnormalities, including uni- or bilateral periodic sharp waves or attenuation of amplitude, focal or generalized slow waves or epileptiform discharges, or electrical seizures. No specific EEG patterns are pathognomonic for HSE, but a focal or lateralized EEG abnormality in the presence of encephalitis is highly suspicious of HSE. In the acute stage, EEG appears to be more sensitive than computerized tomography or radioisotope brain scanning. The EEG findings tend to differ in the course of illness, and the periodic discharges occur only during the acute stage. The EEG findings in either the acute stage or long-term follow-up do not predict the chance of survival or severity of disability, and EEG changes appear to lag behind the clinical changes. EEG results can become normal in both adults and neonates when the acute stage is over.     

Diagnosis of herpes simplex encephalitis

In a series of six cases of encephalitis caused by herpes simplex virus, type 1, the diagnostic and prognostic value of the electroencephalogram (EEG) was investigated. Special interest was focused on the time relationship between the appearance of abnormal EEG findings, the initial clinical symptoms and the changes in cranial computed tomography (CT). The characteristic periodic EEG pattern can be demonstrated within 2 days of disease, before typical structural changes appear in CT. A unilateral periodic pattern may be associated with a good prognosis, where-as all patients with bilateral changes died in spite of specific antiviral therapy.     

Relapse of herpes simplex encephalitis

This report describes a child with herpes simplex virus (HSV) encephalitis who improved dramatically while being treated with acyclovir but subsequently had neurological deterioration and died. A severe necrotizing process was present in the brain at autopsy but there were no focal areas of demyelination and poor inflammatory response. HSV was not cultured from brain biopsy during relapse or autopsy. Fourteen previous cases of relapsing herpes encephalitis are reviewed and treatment regime and mechanisms of relapse are discussed.     

Herpes simplex encephalitis with herpes simplex retinitis

The association of herpes simplex encephalitis and herpes simplex retinitis is rare in adults. The case presented indicates that the manifestation of retinitis after herpes simplex encephalitis is infectious and not immunologic in origin. Retinal infection results either from neuron-to-neuron transmission of viruses along the optic nerve or from recurrent viral infection. Treatment with acyclovir improves the otherwise rather poor prognosis of combined herpes simplex encephalitis and retinitis. In this case a second course of systemic treatment with acyclovir was effective.