Published online August 1, 2007
PEDIATRICS Vol. 120 No. 2 August 2007, pp. e442-e446 (doi:10.1542/10.1542/peds.2006-3757)
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Pelligra, G.
Right arrow Articles by Osiovich, H.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Pelligra, G.
Right arrow Articles by Osiovich, H.
Related Collections
Right arrow Infectious Disease & Immunity
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Facebook   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

EXPERIENCE & REASON

Brainstem Involvement in Neonatal Herpes Simplex Virus Type 2 Encephalitis

Gustavo Pelligra, MDa, Niamh Lynch, MDb, Steven P. Miller, MDb, Michael A. Sargent, MDc and Horacio Osiovich, MDa

Divisions of a Neonatology
b Neurology, Department of Pediatrics
c Department of Radiology, Children's and Women's Health Centre of British Columbia, Vancouver, British Columbia, Canada

ABSTRACT

Herpes simplex virus encephalitis in the newborn typically involves the cerebral cortex in a widespread manner. Herpes simplex virus type 2 rarely involves the brainstem. Here we report a 16-day-old infant with predominant brainstem and cerebellar involvement secondary to herpes simplex virus type 2 infection. Diffusion-weighted MRI performed 3 days after the onset of symptoms revealed restricted diffusion mainly in brainstem and cerebellar structures. No abnormal findings were seen on conventional MRI. Subsequent MRI scans showed evolution of the brain injury with extension along the corticospinal tracts. However, there was no evidence of any other supratentorial gray or white matter injury. This is the first report of predominant brainstem involvement in neonatal herpes simplex virus type 2 encephalitis. In addition, the importance of performing diffusion-weighted sequences to detect early central nervous system involvement and serial MRI to follow the evolution of central nervous system lesions is emphasized.

Key Words: herpes simplex virus • encephalitis • brainstem • magnetic resonance imaging

Abbreviations: HSV, herpes simplex virus • CNS, central nervous system • CSF, cerebrospinal fluid • PCR, polymerase chain reaction • EEG, electroencephalogram

Accepted Apr 3, 2007.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?