Selected abstracts:

1.                  Denne C, Kleines M, Dieckhofer A, Ritter K, Scheithauer S, Merz U, Hausler M.   Intrathecal synthesis of anti-viral antibodies in pediatric patients. Eur J Paediatr Neurol. 2007 Jan;11(1):29-34.

Department of Pediatrics, RWTH, University Hospital of Aachen, Pauwelsstrasse 30, 52064 Aachen, Germany. denne.christian@gmx.net

INTRODUCTION: Detection of intrathecal synthesis of specific antibodies (antibody index (AI)) is an established method to prove cerebral viral infection. Experience on its clinical application in large patient groups, however, is sparse. METHODS: Retrospective analysis of pediatric patients with positive viral AI treated at RWTH Aachen University Hospital between 1999 and 2005. RESULTS: 63 patients were studied, including 14 with encephalitis, 12 with neuritis, nine with cerebral vasculitis, six with multiple sclerosis (MS), five with severe cephalgia, five with psychiatric symptoms, three with hearing loss, two with seizures, three with white matter diseases, two with movement disorders, one with meningococcal meningitis and one with sinus venous thrombosis. Seven had several positive AI among them only one patient with MS. Of the 51 patients with a single positive AI and not having MS, 16 showed a positive AI for herpes simplex-, 13 for varicella zoster-, nine for Epstein-Barr-, four for cytomegalo-, four for mumps-, three for rubella- and two for measles virus. Frequent combinations were varicella zoster virus (VZV) and vasculitis (n = 8), herpes simplex virus (HSV) and neuritis (n = 6), Epstein-Barr virus (EBV) (n = 5), respectively, VZV (n = 4) and encephalitis as wells as mumps virus (n = 2) and hearing loss. Matched polymerase chain reaction (PCR) and AI data were available in 25 patients. PCR was simultaneously positive in three cases only. DISCUSSION: AI testing identifies a similar spectrum of pathogens as known from cerebrospinal fluid (CSF) PCR studies. It complements the PCR and increases the chance for adequate diagnosis and treatment of patients with assumed cerebral viral infections.

2.                  Sakai K, Matsumoto Y, Nozaki I, Yamada M. Acute autonomic sensory and motor neuropathy associated with central nervous system disturbance. J Clin Neurosci. 2007 Mar;14(3):275-8.

Department of Neurology and Neurobiology of Aging, Kanazawa University Graduate, School of Medical Science, 13-1 Takaramachi, Kanazawa 920-8054, Japan. ksakai@bri.niigata-u.ac.jp

We report a 45-year-old woman with acute autonomic sensory and motor neuropathy (AASMN) showing central nervous system (CNS) disturbance. She presented with disturbance of consciousness, complex partial seizures with automatisms, autonomic, sensory and motor neuropathy, showing severe orthostatic hypotension and neurogenic bladder. Nerve conduction studies and nerve biopsy indicated axonal degeneration involving both the myelinated and unmyelinated fibers. Muscle biopsy revealed neurogenic muscular atrophy. Electroencephalogram revealed theta wave activities and sharp wave abnormalities in the frontal lobe. Intravenous immunoglobulin therapy resulted in complete recovery of consciousness levels, but no obvious improvement of the other symptoms. Only eight patients with AASMN have been reported. This is the first report of AASMN showing CNS disturbance. Perivascular lymphocytic infiltration into the temporal lobe and brain stem was described in an autonomic neuropathy patient. An inflammatory pathogenesis of the CNS disturbance associated with this autonomic neuropathy was proposed.

Diagnosis, Diagnostics, Immunodiagnosis & Immunodiagnostics:

15790.  Dhawan SS. Herpes zoster ophthalmicus and syndrome of inappropriate antidiuretic hormone  secretion. Am J Med Sci. 2007 Jan;333(1):56-7. Review. 

15791.  Gilden DH, Mahalingam R, Cohrs RJ, Tyler KL.  Herpesvirus infections of the nervous system. Nat Clin Pract Neurol. 2007 Feb;3(2):82-94. Review.  

15792.  Gumus H, Kumandas S, Per H, Tahan F, Koklu E, Karakukcu M.  Unusual presentation of herpes simplex virus encephalitis: bilateral thalamic involvement and normal imaging of early stage of the disease. Am J Emerg Med. 2007 Jan;25(1):87-9.

15793.  Listernick R.  A 10-day-old infant with seizures. Pediatr Ann. 2007 Feb;36(2):78-82.

15794.  Melaiki BT, Thabet F, Anjum SB, Amin A.  Acute cerebellitis with hydrocephalus and brainstem compression. Arch Dis Child. 2007 Jan;92(1):38.

15795.  Smirniotopoulos JG, Murphy FM, Rushing EJ, Rees JH, Schroeder JW.  Patterns of contrast enhancement in the brain and meninges. Radiographics. 2007 Mar-Apr;27(2):525-51. Review. 

Pathogenesis:

15796.  Nguyen ML, Blaho JA.  Apoptosis during herpes simplex virus infection. Adv Virus Res. 2007;69:67-97. Review.