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Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1991 Nov;54(11):1001–1003. doi: 10.1136/jnnp.54.11.1001

Brain biopsy in the management of focal encephalitis.

N E Anderson 1, E W Willoughby 1, B J Synek 1, M C Croxson 1, G L Glasgow 1
PMCID: PMC1014625  PMID: 1666121

Abstract

The value of a brain biopsy in diagnosis and management of suspected herpes simplex encephalitis was studied in 29 patients (16 prospectively and 13 retrospectively). The biopsy showed herpes simplex encephalitis in eight, culture-negative encephalitis in 14, and was normal in three patients. It provided an alternative diagnosis in four patients, for two of whom curative treatment was available. The biopsy was complicated by a fatal intracranial haemorrhage in one patient. The low yield of alternative diagnoses suggests that a brain biopsy is not justified in the routine investigation of focal encephalitis.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Caplan L. R. Brain biopsy in herpes simplex encephalitis. N Engl J Med. 1980 Sep 18;303(12):700–701. [PubMed] [Google Scholar]
  2. Fishman R. A. No, brain biopsy need not be done in every patient suspected of having herpes simplex encephalitis. Arch Neurol. 1987 Dec;44(12):1291–1292. doi: 10.1001/archneur.1987.00520240063014. [DOI] [PubMed] [Google Scholar]
  3. Hanley D. F., Johnson R. T., Whitley R. J. Yes, brain biopsy should be a prerequisite for herpes simplex encephalitis treatment. Arch Neurol. 1987 Dec;44(12):1289–1290. doi: 10.1001/archneur.1987.00520240061013. [DOI] [PubMed] [Google Scholar]
  4. Kaufman H. H., Catalano L. W., Jr Diagnostic brain biopsy: a series of 50 cases and a review. Neurosurgery. 1979 Feb;4(2):129–136. doi: 10.1227/00006123-197902000-00004. [DOI] [PubMed] [Google Scholar]
  5. Kennedy P. G. A retrospective analysis of forty-six cases of herpes simplex encephalitis seen in Glasgow between 1962 and 1985. Q J Med. 1988 Jul;68(255):533–540. [PubMed] [Google Scholar]
  6. Kohl S., James A. R. Herpes simplex virus encephalitis during childhood: importance of brain biopsy diagnosis. J Pediatr. 1985 Aug;107(2):212–215. doi: 10.1016/s0022-3476(85)80127-x. [DOI] [PubMed] [Google Scholar]
  7. Lakeman F. D., Koga J., Whitley R. J. Detection of antigen to herpes simplex virus in cerebrospinal fluid from patients with herpes simplex encephalitis. J Infect Dis. 1987 Jun;155(6):1172–1178. doi: 10.1093/infdis/155.6.1172. [DOI] [PubMed] [Google Scholar]
  8. Landry M. L., Booss J., Hsiung G. D. Duration of vidarabine therapy in biopsy-negative herpes simplex encephalitis. JAMA. 1982 Jan 15;247(3):332–334. [PubMed] [Google Scholar]
  9. Nahmias A. J., Whitley R. J., Visintine A. N., Takei Y., Alford C. A., Jr Herpes simplex virus encephalitis: laboratory evaluations and their diagnostic significance. J Infect Dis. 1982 Jun;145(6):829–836. doi: 10.1093/infdis/145.6.829. [DOI] [PubMed] [Google Scholar]
  10. Powell K. F., Anderson N. E., Frith R. W., Croxson M. C. Non-invasive diagnosis of herpes simplex encephalitis. Lancet. 1990 Feb 10;335(8685):357–358. doi: 10.1016/0140-6736(90)90648-o. [DOI] [PubMed] [Google Scholar]
  11. Schroth G., Gawehn J., Thron A., Vallbracht A., Voigt K. Early diagnosis of herpes simplex encephalitis by MRI. Neurology. 1987 Feb;37(2):179–183. doi: 10.1212/wnl.37.2.179. [DOI] [PubMed] [Google Scholar]
  12. Whitley R. J., Alford C. A., Hirsch M. S., Schooley R. T., Luby J. P., Aoki F. Y., Hanley D., Nahmias A. J., Soong S. J. Vidarabine versus acyclovir therapy in herpes simplex encephalitis. N Engl J Med. 1986 Jan 16;314(3):144–149. doi: 10.1056/NEJM198601163140303. [DOI] [PubMed] [Google Scholar]
  13. Whitley R. J., Cobbs C. G., Alford C. A., Jr, Soong S. J., Hirsch M. S., Connor J. D., Corey L., Hanley D. F., Levin M., Powell D. A. Diseases that mimic herpes simplex encephalitis. Diagnosis, presentation, and outcome. NIAD Collaborative Antiviral Study Group. JAMA. 1989 Jul 14;262(2):234–239. [PubMed] [Google Scholar]
  14. Whitley R. J., Soong S. J., Dolin R., Galasso G. J., Ch'ien L. T., Alford C. A. Adenine arabinoside therapy of biopsy-proved herpes simplex encephalitis. National Institute of Allergy and Infectious Diseases collaborative antiviral study. N Engl J Med. 1977 Aug 11;297(6):289–294. doi: 10.1056/NEJM197708112970601. [DOI] [PubMed] [Google Scholar]
  15. Whitley R. J., Soong S. J., Hirsch M. S., Karchmer A. W., Dolin R., Galasso G., Dunnick J. K., Alford C. A. Herpes simplex encephalitis: vidarabine therapy and diagnostic problems. N Engl J Med. 1981 Feb 5;304(6):313–318. doi: 10.1056/NEJM198102053040602. [DOI] [PubMed] [Google Scholar]
  16. Whitley R. J., Soong S. J., Linneman C., Jr, Liu C., Pazin G., Alford C. A. Herpes simplex encephalitis. Clinical Assessment. JAMA. 1982 Jan 15;247(3):317–320. [PubMed] [Google Scholar]

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