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Diffusion-weighted MRI in herpes simplex encephalitis: a report of three cases

  • Diagnostic Neuroradiology
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Abstract

Herpes simplex virus encephalitis (HSVE) is the most frequent fatal viral infection of the brain. Because antiviral treatment may improve the prognosis significantly, early diagnosis is mandatory. Imaging diagnosis rests on conventional MRI for the visualization of lesions in the limbic system, the hallmark of HSVE. Diffusion-weighted MRI (DW-MRI) has not been used for the evaluation of HSVE. We report on the DW-MRI findings in three patients with HSVE, who had cortical diffusion abnormalities in affected brain parenchyma, partially as the initial or most sensitive sign of encephalitis. Sequential imaging showed that the diffusion abnormality started to return to normal after 2 weeks in the presence of persistent contrast uptake. Thus, DW-MRI may be a valuable tool for early detection and diagnosis of HSVE whereas contrast-enhanced images are indispensable after the first week.

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References

  1. Whitley RJ (1990) Viral encephalitis. N Engl J Med 323:242–250

    CAS  PubMed  Google Scholar 

  2. Kennedy PG, Chaudhuri A (2002) Herpes simplex encephalitis. J Neurol Neurosurg Psychiatry 73:237–238

    Article  CAS  PubMed  Google Scholar 

  3. Akhan SC, Coskunkan F, Mutlu B, Gundes S, Vahaboglu H, Willke A (2001) A probable case of herpes simplex encephalitis despite negative PCR findings. Infection 29:359–361

    Article  CAS  PubMed  Google Scholar 

  4. Baringer JR (2000) Herpes simplex virus encephalitis. In: Davis LE, Kennedy PG (eds) Infectious diseases of the nervous system. Butterworth-Heinemann, Oxford, pp 139–164

  5. Zimmerman RD, Russell EJ, Leeds NE, Kaufman D (1980) CT in the early diagnosis of herpes simplex encephalitis. AJR Am J Roentgenol 134:61–66

    CAS  PubMed  Google Scholar 

  6. Schroth G, Gawehn J, Thron A, Vallbracht A, Voigt K (1987) Early diagnosis of herpes simplex encephalitis by MRI. Neurology 37:179–183

    CAS  PubMed  Google Scholar 

  7. Demaerel P, Wilms G, Robberecht W, Johannik K, Van Hecke P, Carton H, Baert AL (1992) MRI of herpes simplex encephalitis. Neuroradiology 34:490–493

    CAS  PubMed  Google Scholar 

  8. Tien RD, Felsberg GJ, Osumi AK (1993) Herpesvirus infections of the CNS: MR findings. AJR Am J Roentgenol 161:167–176

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Neuroradiology, University Hospital Tübingen, Hoppe-Seyler-Strasse 3, 72076, Tübingen, Germany

    W. Küker, T. Nägele & S. Heckl

  2. Department of Neurology, Medical School, University of Tübingen, Tübingen, Germany

    F. Schmidt & U. Herrlinger

Authors
  1. W. Küker
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  2. T. Nägele
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  3. F. Schmidt
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  4. S. Heckl
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  5. U. Herrlinger
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Corresponding author

Correspondence to W. Küker.

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Küker, W., Nägele, T., Schmidt, F. et al. Diffusion-weighted MRI in herpes simplex encephalitis: a report of three cases. Neuroradiology 46, 122–125 (2004). https://doi.org/10.1007/s00234-003-1145-3

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  • DOI: https://doi.org/10.1007/s00234-003-1145-3

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