description of a case and review of the literature [Rev Neurol.2013] -Medes

HSV Eraser Protocol
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BARON J, BLACKSMITH-VELAZQUEZ S, M RUIZ-PIÑERO, PEDRAZA MI, RED-RELLO S, GUERRERO-PEAR AL Journal of Neurology 2013; 57 (10): 451-454 Article type: Case report Author Summary Introduction. Infection Epstein-Barr virus (EBV) can lead ? ? both as primary infection or chronic active infection reactivation ? ? several clinical forms of involvement of the central nervous system. We report a case of encephalitis caused by EBV viral reactivation in an immunocompetent patient, who initially pretended, from the point of view clinical and electroencephalographic, encephalitis herpes simplex virus type 1 (HSV-1). Clinical case. 51 year old male with a history of herpes zoster back in the days before. He went to emergency room for seven-day oppressively holocraneal headache and fever; 24 hours before admission, he suffered drowsiness and impaired speech.

The neurological examination revealed nuchal rigidity and dysphasia. In the cerebrospinal fluid pleocytosis (422 cells / mm3) with 98% of mononuclear cells, and normal CSF glucose and protein concentration was evident. normal brain MRI and EEG with periodic lateralized epileptiform discharges in the left temporal region. He was treated with intravenous acyclovir; kidney failure led to his switch to oral valaciclovir with clinical resolution and improvement of licuorales parameters. The polymerase chain reaction in the cerebrospinal fluid was positive for EBV and negative for other neurotropic virus. Blood, serology for EBV IgG was positive, and negative with IgM and heterophile antibodies. Conclusions. EBV infection may lead to disseminated acute encephalitis affect various locations or central nervous system, particularly the cerebellum. Less frequent are the imitators boxes HSV-1. When encephalitis relates to viral reactivation can be detected, as in our case, precipitants. Introduction. Infection Epstein-Barr virus (EBV) can lead ? ?


both as primary infection or chronic active infection reactivation ? ? several clinical forms of involvement of the central nervous system. We report a case of encephalitis caused by EBV viral reactivation in an immunocompetent patient, who initially pretended, from the point of view clinical and electroencephalographic, encephalitis herpes simplex virus type 1 (HSV-1). Clinical case. 51 year old male with a history of herpes zoster back in the days before. He went to emergency room for seven-day oppressively holocraneal headache and fever; 24 hours before admission, he suffered drowsiness and impaired speech. The neurological examination revealed nuchal rigidity and dysphasia. In the cerebrospinal fluid pleocytosis (422 cells / mm3) with 98% of mononuclear cells, and normal CSF glucose and protein concentration was evident. normal brain MRI and EEG with periodic lateralized epileptiform discharges in the left temporal region. He was treated with intravenous acyclovir; kidney failure led to his switch to oral valaciclovir with clinical resolution and improvement of licuorales parameters. The polymerase chain reaction in the cerebrospinal fluid was positive for EBV and negative for other neurotropic virus. Blood, serology for EBV IgG was positive, and negative with IgM and heterophile antibodies.

Conclusions. EBV infection may lead to disseminated acute encephalitis affect various locations or central nervous system, particularly the cerebellum. Less frequent are the imitators boxes HSV-1. When encephalitis relates to viral reactivation can be detected, as in our case, precipitants. INTRODUCTION. Infection by the Epstein-Barr virus (EBV) ? ? Either as a primary infection, reactivation or to an active chronic infection ? ? can give rise to Several clinical forms of the Involvement of the central nervous system. We report a case of encephalitis due to viral reactivation by EBV produced in an immunocompetent patient INITIALLY Which mimicked, from the clinical and electroencephalographic point of view, encephalitis due to herpes simplex virus type 1 (HSV-1). CASE REPORT. A 51-year-old male Who Had Reported the presence of dorsal herpes zoster some days earlier.

The patient visited the emergency department after suffering a headache and oppressive holocranial febricula for seven days; 24 hours before admission to hospital, I was suffering from drowsiness and language disorder. The neurological examination revealed stiffness in the back of the neck and dysphasia. An analysis of the cerebrospinal fluid revealed pleocytosis (422 cells / mm3) With 98% of the normal mononuclear cells and glucose concentration and protein levels in cerebrospinal fluid. Magnetic resonance imaging of the brain and electroencephalogram readings Were lateralised periodic epileptiform With regular discharges in the left temporal region. Intravenous acyclovir treatment was Initiated, but renal failure meant It Had to Be With changed to oral valacyclovir clinical resolution and improvement of the liquoral parameters. Polymerase chain reaction in the cerebrospinal fluid was positive for EBV and negative for the other neurotropic viruses. In blood, the serology test for EBV IgG was positive With, while IgM and heterophile antibody tests Were negative. CONCLUSIONS. EBV infection can give rise to acute disseminated encephalomyelitis or several locations in the Affect the central nervous system, Especially the cerebellum. Clinical pictures mimicking HSV-1 are less frequent. When encephalitis is related to viral reactivation, precipitating factors can be detected, as in our case. Keywords: Acyclovir, Adults middle age, clinical cases, diagnosis, EEG, Encephalitis, viral Encephalitis, Men, Infections Epstein-Barr, Neurology, Chain Reaction virus polymerase, Review, Treatment, Drug therapy, valacyclovir MEDES ID: 86262

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