viral infection of nervous system

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

Viral Infections of the Nervous System


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'he Syndrome of Acute Anterior(oliomyelitis

"tiology)

poliovirus

*oxsac+ie virus A and ,

echoviruses



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*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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(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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'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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*linical 8anifestations

radicular pain

vesicular cutaneous eruption over t$o4three dermatomes9 thoracic mostfre7uent:

sensory impairment of dermatomes

involved



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(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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Viral causes

"nteroviruses 9;6=:

8umps

Herpes simplex type 2 and "pstein4,arrvirus

>ymphocytic choriomeningitis

Adenoviruses

HIV



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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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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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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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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



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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

viral infection of nervous system

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