0482

CLINICAL AND MRI STUDY OF THE HERPES SIMPLEX VIRUS ENCEPHALITIS IN CHILDREN

Li YH¹, Jiang B²

The first affiliated hospital of Sun Yat-sen University of

Medical Sciences, Guangzhou, China

Objectives: To study the clinical characteristics and MRI features of herpes simplex virus encephalitis (HSVE) in children and the factors impact its prognosis.

Methods: Anti HSV IgM (type ⅠandⅡ) in cerebrospinal fluid (CSF) sample collected on 2 to 22 days after onset of neurologic symptoms were dected by enzyme-linked immunosorbent assay (ELISA) in 11 of the 13 children diagnosed as HSVE according to the HSV DNA detected by polymerase chain reaction (PCR) in CSF samples. The proteins in CSF were studied before and after treatment in all 13 patients. 11 of the 13 patients had MRI scan during the acute phase and 5 had a MRI follow-up 6 months after the first onset.

Result: 7 of the 12 CSF samples collected 5 days or longer after the onset of symptoms were positive, whereas 5 collected within the 5 days were negative. Of the 4 children with sustained abnormal CSF alteration 1 month after treatment, 2 were confirmed to be complicated with other encephalitis caused by toxoplasmosis and cysticercosis, and 3 months later the CSF in the other 2 returned to be normal. After successful treatment, 6 patients recovered completely, 7 had sequelae. Of the 11 children performed MRI during the acute stage of HSVE, 9 were found abnormal signal foci within the parietal, occipital lobes and internal capsule. On the follow-up MRI conducted in 5 children, 2 were found unchanged diffuse abnormalities, while the other 3 had become normal completely.

Conclusion: The combination of CSF HSV DNA, specific antibodies and MRI scan should be useful to the early diagnosis of HSVE. Other infectious pathogens should be discussed if the CSF continued to be abnormal after the acute phase in spite of the successful therapy. MRI would be helpful to follow up the encephalitis and predict its prognosis.