Abstract
Reliable information on acute viral infections of the central nervous system (CNS) in Canadian children has not been available. To investigation this disease in Halifax the medical records of 180 patients with presumed or definite acute viral CNS infection diagnosed at the Izaak Walton Killam Hospital for Children over an 8-year period were reviewed. The yearly incidence was estimated at 19.5/100 000 for children up to 16 years of age, and the peak incidence was in July, August and September. The cause was determined in 64 (36%) of the 180 patients; it was most commonly a known infectious disease -- mumps (in 24 patients) or varicella (in 9 patients). An enterovirus was responsible in nine cases, herpes simplex virus in eight and measles virus in six. The clinical manifestations were variable and included apnea in three infants who would otherwise have been considered to have nearly suffered the sudden infant death syndrome. Localizing features were present on the electroencephalograms of nine patients, including six with herpes simplex infection. Serologic study of paired serum samples obtained during the acute phase of the illness and during convalescence was the most useful laboratory method of establishing the diagnosis. As medical therapy for specific causes of acute viral CNS infection advances, greater attention should be placed on establishing the correct diagnosis.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- ADAIR C. V., GAULD R. L., SMADEL J. E. Aseptic meningitis, a disease of diverse etiology: clinical and etiologic studies on 854 cases. Ann Intern Med. 1953 Oct;39(4):675–704. doi: 10.7326/0003-4819-39-4-675. [DOI] [PubMed] [Google Scholar]
- Butler I. J., Johnson R. T. Central nervous system infections. Pediatr Clin North Am. 1974 Aug;21(3):649–668. doi: 10.1016/s0031-3955(16)33028-0. [DOI] [PubMed] [Google Scholar]
- Chalhub E. G., Devivo D. C., Siegel B. A., Gado M. H., Feigin R. D. Coxsackie A9 focal encephalitis associated with acute infantile hemiplegia and porencephaly. Neurology. 1977 Jun;27(6):574–579. doi: 10.1212/wnl.27.6.574. [DOI] [PubMed] [Google Scholar]
- Deibel R., Schryver G. D. Viral antibody in the cerebrospinal fluid of patients with acute central nervous system infections. J Clin Microbiol. 1976 Apr;3(4):397–401. doi: 10.1128/jcm.3.4.397-401.1976. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Friedman H., Ch'ien L., Parham D. Virus in brain of child with hemiplegia, hemiconvulsions, and epilepsy. Lancet. 1977 Sep 24;2(8039):666–666. doi: 10.1016/s0140-6736(77)92540-5. [DOI] [PubMed] [Google Scholar]
- Lauter C. B. Herpes simplex encephalitis: a great clinical challenge. Ann Intern Med. 1980 May;92(5):696–698. doi: 10.7326/0003-4819-92-5-696. [DOI] [PubMed] [Google Scholar]
- Mohsenifar Z., Gillbert R. P., Landsburg M. Unusual presentation of aseptic meningitis. Postgrad Med. 1977 Sep;62(3):227–229. doi: 10.1080/00325481.1977.11714624. [DOI] [PubMed] [Google Scholar]
- Peters A. C., Vielvoye G. J., Versteeg J., Bots G. T., Lindeman J. ECHO 25 focal encephalitis and subacute hemichorea. Neurology. 1979 May;29(5):676–681. doi: 10.1212/wnl.29.5.676. [DOI] [PubMed] [Google Scholar]
- Torphy D. E., Ray C. G., Thompson R. S., Fox J. P. An epidemic of aseptic meningitis due to echo-virus type 30: epidemiologic features and clinical and laboratory findings. Am J Public Health Nations Health. 1970 Aug;60(8):1447–1455. doi: 10.2105/ajph.60.8.1447. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Williams B. B., Lerner A. M. Some previously unrecognized features of herpes simplex virus encephalitis. Neurology. 1978 Nov;28(11):1193–1196. doi: 10.1212/wnl.28.11.1193. [DOI] [PubMed] [Google Scholar]