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7/23/2019 Viral Infection of Nervous System
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Viral Infections of the Nervous
System
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Six Viral Syndromes
1. Acute anterior poliomyelitis
2. Herpes Zoster gangionitis
. Acute aseptic meningitis !. Acute "ncephalitis or
meningoencephalitis
#. Slo$ virus infections
%. AI&S
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'he Syndrome of Acute Anterior(oliomyelitis
"tiology)
poliovirus
*oxsac+ie virus A and ,
echoviruses
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'he Syndrome of Acute Anterior(oliomyelitis
*linical -eatures
fever malaise headache nausea andvomiting
sti/ness and aching muscles
mild meningeal irritation
$ea+ness and paralysis of muscles
0accid lo$er motor neuron type
asymmetrical
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'he Syndrome of Acute Anterior(oliomyelitis
(athology
destruction of anterior horn cells $ithphagocytosis y microglia gliosis andperivascular meningeal inltrates
,ular motor nuclei dentate nuclei andmotor cortex may also e involved
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'he Syndrome of Acute Anterior(oliomyelitis
'reatment)
(revention $ith 3ral polio vacine
Viral Infections of the Nervous SystemTable of Contents
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'he syndrome of HerpesZoster
A.+.a. ) Shingles
4# cases 5 166666 5 year
more fre7uent in elderly and in those$ith malignancy
It proaly reprsents reactivation of
varicella infection in sensory ganglia
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'he syndrome of HerpesZoster
*linical 8anifestations
radicular pain
vesicular cutaneous eruption over t$o4three dermatomes9 thoracic mostfre7uent:
sensory impairment of dermatomes
involved
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'he syndrome of HerpesZoster
(athology
Acyclovir ;66 mg # times5day
(rednisome may help reduce (ostherpetic neuralgia
*arama
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'he Syndrome of Aseptic8eningitis
Headache fever signs of meningealirritation
lymphocytic pleocytosis $ith normalglucose
photophoia and pain on eyemovement
dro$siness and confusion may epresent
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'he Syndrome of Aseptic8eningitis
Viral causes
"nteroviruses 9;6=:
8umps
Herpes simplex type 2 and "pstein4,arrvirus
>ymphocytic choriomeningitis
Adenoviruses
HIV
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'he Syndrome of Aseptic8eningitis
Nonviral *auses
Spirochetal infections
8ycoplasma pneumoniae
,acterial infections overlying meninges
*arinomatous meningitis
?ecurrent in0ammatory meningitides
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'he Syndrome of Acute"ncephalitis
-erile illness
syndrome of meningitis
impairment of consciousness focal neurologic decits
usually seasonal
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'he Syndrome of"ncephalitis
"tiology 8umps
Aroviruses
Herpes simplex >ymphocytic choriomeningitis
"nteroviruses
*ytomegalovirus
Adenoviruses
?aies
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'he Syndrome of"ncephalitis
Herpes Simplex Sporadic throughout the year
due to type 2 herpes simplex virus
fever headache confusion stupor and coma overseveral days
(athology) lesions in the inferior and medial partsof the temporal loes as $ell as inferior part offrontal loes
>esions) in0ammation pannecrosis hemorrhage
intranuclear eosinophilic inclusions in neurons
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'he Syndrome of"ncephalitis
Herpes Simplex
&iagnosis
*' and 8?I4temporal and frontal loe lesions
*S-) mononuclear pleocytosis elevatedprotein normal glucose and ?,*s
""@) (eriodic high voltage complexes in theteporal leads and sloe 24 per second slo$
$aves
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'he Syndrome of"ncephalitis
Herpes Simplex
(rognosis) aout half do not survive
'reatment)
acyclovir
No steroids
Supportive
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Slo$ Viruses
Suacute Sclerosing (anencephalitis
appears in children and adolescentsyears after a measles attac+
dementia focal or generali
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Slo$ Viruses
(rogressive 8ultifocal >eu+oencephalopathy
sually associated $ith Hodg+inBs diseaselymphoma chronic leu+emia
4% months development of focal cereralrainstem and cereellar signs
&emyelinating lesions
Inclusion odies in oligodendroglia and astrocytes
No treatment
Viral Infections of the Nervous SystemTable of Contents
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Slo$ Virus Infections
Suacute spongifrom encephalopathy
*reut
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Slo$ Virus Infections
Suacute spongifrom encephalopathy
*reut
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'he Ac7uired Immune &eciencySyndrome
Ac7uired profound depression of cellmediated immunity
H'>V
3pportunistic infections
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'he Ac7uired Immune &eciencySyndrome
,rain)Nonfocal
AI&s dementia comple