Acute Viral Encephalitis

  • Miguel Mateos-Mora
  • Kenneth R. Ratzan
Part of the Clinical Topics in Infectious Disease book series (CLIN.TOP.INFECT)


In the simplest of terms, encephalitis is defined as inflammation of the brain. It can be caused by many etiologic agents, including viruses, bacteria, parasites, and fungi. Viral encephalitis may be caused either by direct viral infection of neuronal tissue with neuronal destruction and the inflammation that accompanies that destruction or by an immunologic process whereby demyelination of white matter and perivenular inflammation occur, a hallmark of postinfectious encephalitis. In either case, the clinical picture is characterized by an acute or subacute onset of neurologic symptoms, such as impairment of mental function, seizures, focal neurologic findings, coma, and abnormalities evidenced by such diagnostic procedures as the electroencephalogram, (EEG) nuclide brain scan, computed tomography (CT) scan, and magnetic-resonance imaging (MRI) of the brain. More often than not, an inflammatory response is present in the cerebrospinal fluid (CSF). In such cases, meningoencephalitis may be a more appropriate term. 1–4 There is very little about the clinical syndrome of viral encephalitis that discriminates among the various etiologic agents. To be sure, Herpes simplex virus (HSV) encephalitis typically causes focal symptoms, rabies virus usually causes hydrophobia, and the postinfectious encephalitis of varicella often produces cerebellar dysfunction. Yet there is so much overlap in the clinical presentation of encephalitis caused by viruses that one cannot rely on the clinical setting alone to make an etiologic diagnosis. Thus, once bacteria, fungi, parasites, and other etiologies are excluded (Table 9-1), the identification of the specific virus causing the encephalitis will depend on viral isolation from the brain or CSF, histologic demonstration of virus by electron microscopy, identification of viral antigen or specific antiviral antibody in spinal fluid, or demonstration of a fourfold change in antibody levels in serum. Despite all these tests, for 60–85% of patients with encephalitis described in large series in the literature, no etiology is determined.3,5–14


Herpes Simplex Virus Herpes Zoster Rabies Virus Hemagglutinating Inhibition Brain Biopsy 
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  1. 1.
    Benson CA, Harris AA: Acute neurologic infections. Med Clin North Am 1986; 70: 987–1011.PubMedGoogle Scholar
  2. 2.
    Ho DD, Hirsch MS: Acute viral encephalitis. Med Clin North Am 1985; 69: 415–429.PubMedGoogle Scholar
  3. 3.
    Koskiniemi M, Manninen V, Vaheri A: Acute encephalitis: a survey of epidemiological, clinical and microbiological features covering a twelve year period. Acta Med Scand 1981; 209: 6115–120.Google Scholar
  4. 4.
    Meyer HM, Johnson RT, Crawford IP, et al: Central nervous system syndromes of “viral” etiology. A study of 713 cases. Am J Med 1960; 29: 334–347.PubMedGoogle Scholar
  5. 5.
    Cherry JD, Shields WD: Encephalitis and meningoencephalitis, in Feigin RD, Cherry JD (eds): Textbook of Pediatric Infectious Diseases, 2nd ed. Philadelphia, WB Saunders, 1987, pp 494–496.Google Scholar
  6. 6.
    Koskiniemi M, Vaheri A: Acute encephalitis of viral origin. Scan J Infect Dis 1982; 14: 181–187.Google Scholar
  7. 7.
    Centers for Disease Control: Encephalitis surveillance, 1978. CDC Annual Summary, May 1981.Google Scholar
  8. 8.
    Kennard C, Swash M: Acute viral encephalitis: its diagnosis and outcome. Brain 1981; 104: 129–148.PubMedGoogle Scholar
  9. 9.
    Ho M: Acute viral encephalitis, in Vinken PJ, Bruyn GW (eds): Handbook of Clinical Neurology: Infections of the Central Nervous System II. New York, North-Holland Publishing Co, 1978, pp 6382.Google Scholar
  10. 10.
    Powell KE, Kappus KD: Epidemiology of St. Louis encephalitis and other acute encephalitides. Adv Neurol 1978; 19: 197–215.PubMedGoogle Scholar
  11. 11.
    Monath TP: Arthropod-borne encephalitides in the Americas. Bull WHO 1979; 57: 513–531.PubMedGoogle Scholar
  12. 12.
    Rennels MB: Arthropod-borne virus infections of the central nervous system. Neurol Clin 1984; 2: 241–254.PubMedGoogle Scholar
  13. 13.
    Centers for Disease Control: Summary of notifiable diseases, United States, 1987. MMWR 1988;36:311, 18–19, 53–59.Google Scholar
  14. 14.
    Beghi E, Nicolosi A, Kurland LT, et al: Encephalitis and aseptic meningitis, Olmstead County, Minnesota, 1950–1981. I. Epidemiology. Ann Neurol 1984; 16: 283–294.PubMedGoogle Scholar
  15. 15.
    Whitley RJ: Herpes simplex infections of the central nervous system. A review. Am J Med 1988; 85 (supp2A): 61–67.Google Scholar
  16. 16.
    Tenser RB: Herpes simplex and herpes zoster. Nervous system involvement. Neurol Clin 1984; 2: 215–240.Google Scholar
  17. 17.
    Griffith JF, CH’ien LT: Herpes simplex virus encephalitis. Diagnostic and treatment considerations. Med Clin North Am 1983; 67: 991–1008.PubMedGoogle Scholar
  18. 18.
    Whitley RJ, Soong SJ, Dolin R, et al: Adenine arabinoside therapy of biopsy-proved herpes simplex encephalitis. National Institute of Allergy and Infectious Diseases Collaborative Antiviral Study. N Engl J Med 1977; 297: 289–294.PubMedGoogle Scholar
  19. 19.
    Smith MG, Lennette EH, Reames HR: Isolation of the virus of herpes simplex and the demonstration of intranuclear inclusions in a case of acute encephalitis. Am J Pathol 1941; 17: 55–68.PubMedGoogle Scholar
  20. 20.
    Whitley RJ, Alford CA, Hirsch MS, et al: Vidarabine versus acyclovir therapy in herpes simplex encephalitis. N Engl J Med 1986; 314: 144–149.PubMedGoogle Scholar
  21. 21.
    Skoldenberg B, Forsgren M, Alestig K, et al: Acyclovir versus vidarabine in herpes simplex encephalitis. Randomized multicentre study in consecutive Swedish patients. Lancet 1984; 2: 707–711.PubMedGoogle Scholar
  22. 22.
    Whitley RJ, Soong SJ, Hirsch MS, et al: Herpes simplex encephalitis: vidarabine therapy and diagnostic problems. N Engl J Med 1981; 304: 313–318.PubMedGoogle Scholar
  23. 23.
    Whitley RI, Nahmias AS, Visintine AM, et al: The natural history of herpes simplex virus infection of mother and newborn. Pediatrics 1980; 66: 489–494.PubMedGoogle Scholar
  24. 24.
    Whitley RJ, Nahmias A.1, Soong SJ: Vidarabine therapy of neonatal herpes simplex virus infection. Pediatrics 1980; 66: 495–501.PubMedGoogle Scholar
  25. 25.
    Kohl S: Herpes simplex virus encephalitis in children. Pediatri Clin North Am 1988; 35: 465–483.Google Scholar
  26. 26.
    Whitley R, Lakeman AD, Nahmias A, et al: DNA restriction-enzyme analysis of herpes simplex virus isolates obtained from patients with encephalitis. N Engl J Med 1982; 307: 1060–1062.PubMedGoogle Scholar
  27. 27.
    Ellison PH, Hanson PA: Herpes simplex: a possible cause of brain-stem encephalitis. Pediatrics 1977; 59: 240–243.PubMedGoogle Scholar
  28. 28.
    Latronico N, Candiani A: Brainstem herpes virus encephalitis (letter). Lancet 1987; 19–2 (8560): 690–691.Google Scholar
  29. 29.
    Sage JI, Weinstein MP, Miller DC: Chronic encephalitis possibly due to herpes simplex virus: two cases. Neurology 1985; 35: 1470–1472.PubMedGoogle Scholar
  30. 30.
    Klapper PE, Cleator GM, Longson M: Mild forms of herpes encephalitis. J Neurol Neurosurg Psychiatry 1984; 47: 1247–1250.PubMedGoogle Scholar
  31. 31.
    Oommen KJ, Johnson PC, Ray CG: Herpes simplex type 2 virus encephalitis presenting as psychosis. Am J Med 1982; 73: 445–448.PubMedGoogle Scholar
  32. 32.
    Olson LC, Buescher EL, Artensein MS, et al: Herpesvirus infections of the human central nervous system. N Engl J Med. 1967; 277: 1271–1277.PubMedGoogle Scholar
  33. 33.
    Leider W, Magoffin RL, Lennette EH, et al: Herpes simplex virus encephalitis and its possible association with reactivated latent infection. N Engl J Med 1965; 273: 341–347.PubMedGoogle Scholar
  34. 34.
    Davis LE, Johnson RT: An explanation for the localization of Herpes simplex encepahlitis. Ann Neurol 1979; 5: 2–5.PubMedGoogle Scholar
  35. 35.
    Drachman DA, Adams RD: Herpes simplex and acute inclusion body encephalitis. Arch Neurol 1962; 7: 61–79.Google Scholar
  36. 36.
    Esiri M: Herpes simplex encephalitis, an immunohistological study of the distribution of viral antigen within the brain. J Neurol Sci 1982; 54: 209–226.Google Scholar
  37. 37.
    Nahmias AJ, Whitley RJ, Visintine AL, et al: Herpes simplex virus encephalitis: Laboratory evaluations and their diagnostic significance. J Infect Dis 1982; 145: 829–836.PubMedGoogle Scholar
  38. 38.
    Johnson RT: Pathogenesis of herpes virus encephalitis. I-Virus pathways to the nervous system of suckling mice demonstrated by fluorescent antibody staining. J Exp Med 1964; 119: 343–356.PubMedGoogle Scholar
  39. 39.
    Johnson RT, Mims CA: Pathogenesis of viral infections of the nervous system. N Engl J Med 1968; 278; 23–30.PubMedGoogle Scholar
  40. 40.
    Barringer JR, Swoveland P: Recovery of Herpes simplex virus from human trigeminal ganglions. N Engl J Med 1973; 288: 648–650.Google Scholar
  41. 41.
    Morawetz RB, Whitley RJ, Murphy DM: Experience with brain bipsy for suspected herpes encephalitis. A review of forty consecutive cases. Neurosurgery 1983; 12: 654–657.PubMedGoogle Scholar
  42. 42.
    Whitley RJ, Soong SJ, Linneman C Jr, et al: Herpes simplex encephalitis: clinical assessment. JAMA 1982; 247: 317–320.PubMedGoogle Scholar
  43. 43.
    Schlageter, J: Herpes simplex encephalitis without CSF lekocytosis. Arch Neurol 1984; 41: 1007–1008.PubMedGoogle Scholar
  44. 44.
    Vaheri A, Keski-Oja J, Salonen EM, et al: Cerebrospinal fluid IgG bands and virus specific IgG, IgM and IgA antibodies in herpes simplex virus encephalitis. J. Neuroimmunol 1982; 3: 247–261.PubMedGoogle Scholar
  45. 45.
    Skoldenberg B, Kalimo K, Carlstrom A, et al: Herpes simplex encephalitis: a serological follow-up study. Synthesis of herpes simplex virus immunoglobulin M, A and G antibodies and development of oligoclonal immunoglobulin G in the central nervous system. Acta Neurol Scand 191;63:273–285.Google Scholar
  46. 46.
    Levine DP, Lauter CB, Lerner AM: Simultaneous serum and CSF antibodies in herpes simplex encephalitis. JAMA 1978; 240: 356–360.PubMedGoogle Scholar
  47. 47.
    Lakeman FD, Koga J, Whitley RJ: Detection of antigen to herpes simplex virus in cerebrospinal fluid from patients with herpes simplex encephalitis. J Infect Dis 1987; 1455: 1172–1178.Google Scholar
  48. 48.
    Boerman RH, Raap AK, VD Ploeg M: Rapid diagnosis of herpes simplex virus type 1 encephalitis by radioactive genome detection in cerebrospinal fluid (letter). Lancet 1987; 1: 94.Google Scholar
  49. 49.
    Redfield DC, Richman D, Albanil, et al: Detection of herpes simplex virus in clinical specimens by DNA hybridization. Diag Microbiol Infect Dis 1983; 1: 117–128.Google Scholar
  50. 50.
    Tenover FC: Diagnostic deoxyribonucleic acid probes for infectious diseases. Clin Microbiol Rev 1988; 1: 82–101.PubMedGoogle Scholar
  51. 51.
    Koskiniemi M, Vaheri A, Manninem V, et al: Herpes simplex virus encephalitis: new diagnostic and clinical features and results of therapy. Arch Neurol 1980; 37: 763–767.PubMedGoogle Scholar
  52. 52.
    Cappel R, Thiry L, Clinet G: Viral antibodies in the CSF after acute CNS infections. Arch Neurol 1975; 32: 629–631.PubMedGoogle Scholar
  53. 53.
    Kahlon J, Chatterjee S, Lakeman FD, et al: Detection of antibodies to herpes simplex virus in the cerebrospinal fluid of patients with herpes simplex encephalitis. J Infect Dis 1987; 155: 38–44.PubMedGoogle Scholar
  54. 54.
    Schoechetman G, Ou C, Jones WK: Polymerase chain reaction. J Infect Dis 1988; 158: 1154–1157.Google Scholar
  55. 55.
    Brodkorb E, Lindqvist M, Jonsson M, et al: Diagnosis of Herpes simplex encephalitis. A comparison between electroencephalography and computed tomography findings. Acta Neurol Scand 1982; 66: 462–471.Google Scholar
  56. 56.
    Smith JB, Westmoreland BF, Reagan TJ, et al: A distinctive clinical EEG profile in herpes simplex encephalitis. Mayo Clin Proc 1975; 50: 469–474.PubMedGoogle Scholar
  57. 57.
    Wolman B, Longson M: Herpes encephalitis. Acta Pediatr Scand 1977; 66: 243–246.Google Scholar
  58. 58.
    Davis JM, Davis KR, Kleinman GM, et al: Computed tomography of herpes simplex encephalitis, with clinicopathological correlation. Radiology 1978; 129: 409–417.PubMedGoogle Scholar
  59. 59.
    Greenberg SB, Taber L, Septimus E, et al: Cornputarized tomography in brain biopsy proven herpes simplex encephalitis. Arch Neurol 1981; 38: 58–59.PubMedGoogle Scholar
  60. 60.
    Schroth G, Gawehn J, Thron A, et al: Early diagnosis of herpes simplex encephalitis in MRI. Neurology 1987; 37: 179–183.PubMedGoogle Scholar
  61. 61.
    Kohl S, James AR: Herpes simplex virus encephalitis during childhood. Importance of brain biopsy diagnosis. J Pediatr 1985; 107: 212–215.PubMedGoogle Scholar
  62. 62.
    Whitley RJ: The frustrations of treating herpes simplex virus infections of the central nervous system (editorial). JAMA 1988; 259: 1067.PubMedGoogle Scholar
  63. 63.
    Craven RB: Togaviruses, in Belshe RB (ed): Text-132 Miguel Mateos-Mora and Kenneth R. Ratzan book of Human Virology. Littleton, NH, PSG 80. Publishing Co, 1984, pp 599–648.Google Scholar
  64. 64.
    Tsai TF, Monath TP: Viral diseases in North America transmitted by arthropods or from vertebrate reservoirs, in Feigin RD, Cherry JD (eds): Textbook 81. of Pediatric Infectious Diseases, 2nd ed. Philadelphia, WB Saunders, 1987, pp 1417–1456.Google Scholar
  65. 65.
    Watts DM, Thompson WH, Yvill TM, et al: Over-wintering of La Crosse virus in Aedes triseriatus. 82. Am J Trop Med Hyg 1974; 23: 694–700.PubMedGoogle Scholar
  66. 66.
    Thompson WH, Beaty BJ: Venereal transmission of La Crosse viruse from male to female Aedes triseriatus. Am J Trop Med Hyg 1978; 27: 187–196.Google Scholar
  67. 67.
    Potter ME, Currier II RW, Pearson JE, et al: Western equine encephalomyelitis in horses in the northern Red River Valley, 1975. J AW MA 1977; 170: 1396–1399.Google Scholar
  68. 68.
    Centers for Disease Control: Arboviral infections of the central nervous system, United States, 1987. MMWR 1988; 37: 506–515.Google Scholar
  69. 69.
    Meyer KF, Haring CM, Howitt BF: The etiology of encephalomyelitis in horses in the San Joaquin Valley, 1930. Science 1931; 74: 227–228.PubMedGoogle Scholar
  70. 70.
    Howitt BF: Recovery of the virus of equine encephalomyelitis from the brain of a child. Science 1938; 88: 455–456.PubMedGoogle Scholar
  71. 71.
    Monath TP: Epidemiology, in Monath TP (ed): St. Louis Encephalitis. Washington, DC, American Public Health Association, 1980, pp 239–312.Google Scholar
  72. 72.
    Longshore WA, Stevens IM, Hollister AC, et al: Epidemiologic observations on acute infectious encephalitis is California, with special reference to the 1952 outbreak. Am J Hyg 1956; 63: 69–86.PubMedGoogle Scholar
  73. 73.
    Schultz DR, Barthal JS, Garret C: Western equine encephalitis with rapid onset of parkinsonism. Neurology 1977; 27: 1095–1096.PubMedGoogle Scholar
  74. 74.
    Calisher CH, Berardi VP, Muth DJ, et al: Specificity of immunoglobulin M and G antibody responses in humans infected with eastern and western equine encephalitis viruses: application to rapid serodiagno-sis. J Clin Microbiol 1986; 23: 369–372.PubMedGoogle Scholar
  75. 75.
    Goldfield M, Sussman O: The 1959 outbreak of eastern encephalitis in New Jersey. Am J Epidemiol 1968; 87: 1–57.PubMedGoogle Scholar
  76. 76.
    Fothergill LD, Dingle JH, Farber S, et al: Human encephalitis caused by the virus of the eastern variety of equine encephalomyelitis. N Engl J Med 1938; 219: 415.Google Scholar
  77. 77.
    McGowan JE, Bryan JA, Gregg MB: Surveillance of arboviral encephalitis in the United States, 1955–1971. Am J Epidemiol 1973; 97: 199–207.PubMedGoogle Scholar
  78. 78.
    Powell KE, Blakey DL: St. Louis encephalitis. The 1975 epidemic in Mississippi. JAMA 1977; 237: 2294–2298.PubMedGoogle Scholar
  79. 79.
    Southern PM Jr, Smith JW, Luby JP, et al: Clinical and laboratory features of epidemic St. Louis encephalitis. Ann Intern Med 1969; 71: 681–689.PubMedGoogle Scholar
  80. 80.
    White MG, Carter NW, Rector FC, et al: Pathophysiology of epidemic St. Louis encephalitis. I-Inappropriate secretion of antidiuretic hormone. Ann Intern Med 1969; 71: 691–702.PubMedGoogle Scholar
  81. 81.
    Chonmaitree T, Baldwin CD, Lucia HL: Role of the virology laboratory in diagnosis and management of patients with central nervous system disease. Clin Microbiol Rev 1989; 2: 1–14.PubMedGoogle Scholar
  82. 82.
    Monath TP, Nystrom RR, Bailey RE, et al: Immunoglobulin M antibody capture enzyme-linked immunosorbent assay for diagnosis of St. Louis encephalitis. J Clin Microbiol 1984; 20: 784–790.PubMedGoogle Scholar
  83. 83.
    Grandien M, Olding-Stenkvist E: Rapid diagnosis of viral infections. Scan J Infect Dis 1984; 16: 1–8.Google Scholar
  84. 84.
    Hammon WM, Reeves WC, Galindo P: Epidemiologic studies of encephalitis in the San Joaquin Valley of California, 1943, with the isolation of viruses from mosquitoes. Am J Hyg 1945; 42: 299–306.PubMedGoogle Scholar
  85. 85.
    Hammon WM, Reeves WC: California encephalitis virus: a newly described agent. Calif Med 1952; 77: 303–309.PubMedGoogle Scholar
  86. 86.
    Thompson WH, Kalfayan B, Anslow RO: Isolation of California encephalitis group virus from a fatal human illness. Am J Epidemiol 1965; 81: 245–253.PubMedGoogle Scholar
  87. 87.
    Peters CJ, Leduc JW: Bunyaviruses, phleboviruses and related viruses, in Belshe RB (ed): Text of Human Virology. Littleton, NH, PSG Publishing Co, 1984, pp 547–598.Google Scholar
  88. 88.
    Thompson WH, Evans AS: California encephalitis virus studies in Wisconsin. Am J Epidemiol 1965; 81: 230–244.PubMedGoogle Scholar
  89. 89.
    Balfour HH Jr, Siem RA, Bauer H, et al: California arbovirus (La Crosse) infections. I-Clinical and laboratory findings in 66 children with meningoencephalitis. Pediatrics 1973; 52: 680–691.PubMedGoogle Scholar
  90. 90.
    Monath TP: Arboviruses of Central and South America, in Feigin RD, Cherry JD (eds): Textbook of Pediatric Infectious Diseases, 2nd ed. Philadelphia, WB Saunders, 1987, pp 1456–1468.Google Scholar
  91. 91.
    Steele JH: Rabies in the Americas and remarks on global aspects. Rev Infect Dis 1988;10(S4):S585- S597.Google Scholar
  92. 92.
    Robinson PA: Rabies virus, in Belshe RB (ed): Textbook of Human Virology. Littleton, NH, PSG Publishing Co, 1984, pp 485–511.Google Scholar
  93. 93.
    Bernard KW, Hattwick MAW: Rabies virus, in Mandel GL, Douglas RG Jr, Benett JE (eds): Principles and Practices of Infectious Diseases, 2nd ed. New York, Wiley Med Publication, 1985, pp 897–907.Google Scholar
  94. 94.
    Atanasiu P, Gamet A: Rabies, in Vinken PJ, Bruyn GW (eds): Handbook of Clinical Neurology. Infections of the Nervous System II. New York, North- Holland Publishing Co, 1978, pp 235–274.Google Scholar
  95. 95.
    Plotkin SA, Clark HF: Rabies, in Feigin RD, Cherry JD (eds): Textbook of Pediatric Infectious Diseases, 2nd ed. Philadelphia, WB Saunders, 1987, pp 1676–1684.Google Scholar
  96. 96.
    Centers for Disease Control: Surveillance Summaries. Rabies Surveillance, United States, 1987. MMWR 1988; 37 (no.SS-4): 1–17.Google Scholar
  97. 97.
    Anderson LJ, Nicholson KG, Tauxe RV, et al: Human rabies in the United States, 1960 to 1979: epidemiology, diagnosis, and presentation. Ann Intern Med 1984; 100: 728–735.PubMedGoogle Scholar
  98. 98.
    Centers for Disease Control: Human rabies-California, 1987. MMWR 1988; 37: 305–308.Google Scholar
  99. 99.
    Dupont JR, Earle KM: Human rabies encephalitis-a study of forty-nine fatal cases with a review of the literature. Neurology 1965; 15: 1023–1034.PubMedGoogle Scholar
  100. 100.
    Hattwick MAW, Weis TT, Stechschulte CJ, et al: Recovery from rabies-a case report. Ann Intern Med 1972; 76: 931–942.PubMedGoogle Scholar
  101. 101.
    Baer GM, Bridbord K, Hui FW: Research towards rabies prevention. Rev Infect Dis 1988;10: (S4)S573–S815.Google Scholar
  102. 102.
    Moore M, Morens DM: Enteroviruses, including polioviruses, in Belshe RB (ed): Textbook of Human Virology. Littleton, NH, PSG Publishing Co, 1984, pp 407–483.Google Scholar
  103. 103.
    Cherry JD: Enteroviruses: polioviruses (poliomyelitis), Coxsackieviruses, echoviruses, and enteroviruses, in Feigin RD, Cherry JD (eds): Textbook of Pediatric Infectious Diseases, 2nd ed. Philadelphia, WB Saunders, 1987, pp 1729–1790.Google Scholar
  104. 104.
    Modlin JE: Coxsackievirus and echovirus, in Mandel GL, Douglas RG Jr, Benett JE (eds): Principles and Practices of Infectious Diseases, 2nd ed. New York, Wiley Med Publication, 1985, pp 814–825.Google Scholar
  105. 105.
    Ratzan KR: Viral meningitis. Med Clin North Am 1985; 69: 399–413.PubMedGoogle Scholar
  106. 106.
    McKinney RE, Katz SL, Wilfert CM: Chronic enteroviral meningoencephalitis in agammaglobulinemic patients. Rev Infect Dis 1987; 9: 334–356.PubMedGoogle Scholar
  107. 107.
    Taber LH, Mirkovic RR, Adam V, et al: Rapid diagnosis of enterovirus meningitis by immunofluorescent staining of SCF leukocytes. Intervirology 1973; 1: 127–134.PubMedGoogle Scholar
  108. 108.
    Tolpin MD, Schauf V: Mumps virus, in Belshe RB (ed): Textbook of Human Virology. Littleton, NH, PSG Publishing Co, 1984, pp 311–331.Google Scholar
  109. 109.
    Brunell PA: Mumps, in Feigin RD, Cherry JD (eds): Textbook of Pediatric Infectious Diseases, 2nd ed. Philadelphia, WB Saunders, 1987, pp 1628–1632.Google Scholar
  110. 110.
    Taylor FB, Toreson WE: Primary mumps meningoencephalitis. Arch Int Med 1963; 112: 216–221.Google Scholar
  111. 111.
    McLean DM, Bach RD, Larke RPB, et al: Mumps meningoencephalitis, Toronto, 1963. Can Med Assoc J 1964; 90: 458–462.PubMedGoogle Scholar
  112. 112.
    Levitt LP, Rich TA, Kinde SW, et al: Central nervous system mumps. Neurology 1970; 20: 829–834.PubMedGoogle Scholar
  113. 113.
    Baum SG, Litman N: Mumps virus, in Mandel GL, Douglas RG Jr, Benett JE (eds): Principles and Practices of Infectious Diseases, 2nd ed. New York, Wiley Med Publication, 1985, pp 871–877.Google Scholar
  114. 114.
    Modlin JF: Measles virus, in Belshe RB (ed): Textbook of Human Virology. Littleton, NH, PSG Publishing Co, 1984, pp 333–360.Google Scholar
  115. 115.
    Centers for Disease Control: Measles encephalitis-United States, 1962–1979. MMWR 1981; 30: 362–364.Google Scholar
  116. 116.
    Centers for Disease Control: Summary of notifiable diseases, United States, 1988. MMWR 1989; 37: 802–803.Google Scholar
  117. 117.
    Cherry JD: Measles, in Feigin RD, Cherry JD (eds): Textbook of Pediatric Infectious Diseases, 2nd ed. Philadelphia, WB Saunders, 1987, pp 1607–1628.Google Scholar
  118. 118.
    Hanninen P, Arstila P, Lang H, et al: Involvement of the central nervous system in acute, uncomplicated measles virus infection. J Clin Microbiol 1980; 11: 610–613.PubMedGoogle Scholar
  119. 119.
    Johnson RT, Griffin DE, Hirsch RL, et al: Measles encephalomyelitis-clinical and immunologic studies. N Engl J Med 1984; 310: 137–141.PubMedGoogle Scholar
  120. 120.
    Centers for Disease Control: Rubella surveillance. Report No. 1, 1969.Google Scholar
  121. 121.
    Centers for Disease Control: Rubella and congenital rubella, United States, 1984–1986. MMWR 1987; 36: 664–675.Google Scholar
  122. 122.
    Preblud SR, Serdula MK, Frank JA, et al. Current status of rubella in the United States, 1969–1979. J Infect Dis 1980; 142: 776–779.PubMedGoogle Scholar
  123. 123.
    Sherman FE, Michaels RH, Kenny FM: Acute encephalopathy (encephalitis) complicating rubella. JAMA 1965; 192: 675–681.PubMedGoogle Scholar
  124. 124.
    Walker JM, Nahmias AJ: Neurologic sequelae of rubella infection. Clin Pediatr 1966; 5: 699–702.Google Scholar
  125. 125.
    Kenny FM, Michaels RH, Davis KS: Rubella encephalopathy. Later psychometric, neurologic, and encephalographic evaluation of seven survivors. Am J Dis Child 1965; 110: 374–380.PubMedGoogle Scholar
  126. 126.
    Weller TH: Varicella and Herpes-zoster. Changing concepts of the natural history, control, and importance of a not-so-benign virus. N Eng J Med 1983;309:1362–1368 and 1434–1440.Google Scholar
  127. 127.
    Brunell PA: Varicella-zoster infections, in Feigin RD, Cherry JD (eds): Textbook of Pediatric Infectious Diseases, 2nd ed. Philadelphia, WB Saunders, 1987, pp 1602–1607.Google Scholar
  128. 128.
    Straus SE: The management of varicella and zoster infections. Inf Dis Clin North Am 1987; 1: 367–382.Google Scholar
  129. 129.
    Hirsch MS, Schooley RT: Treatment of herpesvirus infections. N Engl J Med 1983; 309: 963–970.PubMedGoogle Scholar
  130. 130.
    Preblud SR: Age-specific risks of varicella complications. Pediatrics 1981; 68: 14–17.PubMedGoogle Scholar
  131. 131.
    Johnson RT, Milbourn PE: Central nervous system manifestations of chicken pox. Can Med Assoc J 1970; 102: 831–834.PubMedGoogle Scholar
  132. 132.
    McCormick WF, Rodnitzky RL, Schochet SS Jr, et al: Varicella-zoster encephalomyelitis. Arch Neurol 1969; 21: 559–570.PubMedGoogle Scholar
  133. 133.
    Appelbaum E, Kreps SI, Sunshine A: Herpes-zoster encephalitis. Am J Med 1962; 32: 25–31.PubMedGoogle Scholar
  134. 134.
    Jemsek H, Greenberg SB, Taber L, et al: Herpeszoster associated encephalitis: clinicopathologic report of 12 cases and review of the literature. Medicine 1983; 62: 81–97.PubMedGoogle Scholar
  135. 135.
    Fleisher GR: Epstein-Barr virus, in Belshe RB (ed): Textbook of Human Virology. Littleton, NH, PSG Publishing Co, 1984, pp 853–886.Google Scholar
  136. 136.
    Lange BJ, Berman PH, Bender J, et al: Encephalitis in infectious mononucleosis: diagnostic considerations. Pediatrics 1976; 58: 877–880.PubMedGoogle Scholar
  137. 137.
    Silverstein A, Steinberg G, Nathanson M: Nervous system involvement in infectious mononucleosis. Arch Neurol 1972; 26: 356–358.Google Scholar
  138. 138.
    Demey HE, Martin JJ, Leus RM, et al: Coma as a presenting sign of Epstein-Barr encephalitis. Arch Int Med 1988; 148: 1459–1461.Google Scholar
  139. 139.
    Halstead CC, Chang RS: Infectious mononucleosis and encephalitis. Recovery of Epstein-Barr virus from spinal fluid. Pediatrics 1979; 64: 257–258.Google Scholar

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© Springer-Verlag New York Inc. 1990

Authors and Affiliations

  • Miguel Mateos-Mora
  • Kenneth R. Ratzan

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