Table 3.
Clinical features and diagnosis of non-HIV infectious diseases with neuropsychiatric manifestations
| Disease | Signs | Focal | CT/MRI | Laboratory Tests | Neuropsychiatric Sequelae |
Treatment |
|---|---|---|---|---|---|---|
| Herpes encephalitis | Fever | Yes | Midline shift | EEG | Difficulties in language function and verbal memory | Intravenous acyclovir |
| Altered mental Status | T2 focal hyperintensities | Lumbar puncture | Semantic aphasia or autism | |||
| Focal neurologic Signs | PCR | Behavioral and personality changes | ||||
| Seizures | Klüver-Bucy syndrome | |||||
| Aggression/ disinhibition | ||||||
| Language impairments | ||||||
|
| ||||||
| Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections | Age of onset between ages 3 and 11 y | No | Basal ganglia enlargement | Antistreptococcal antibody titers | OCD or tic disorder symptoms | Plasma exchange intravenous immunoglobulin |
| OCD or tic disorder symptoms | ESR, CRP | Other movement disorders | ±PCN or azithromycin | |||
| Temporal association between symptoms and group A-hemolytic streptococcal infection | D8/17 B-lymphocyte marker | |||||
| ↑antibasal ganglia Ab’s | ||||||
|
| ||||||
| Neurocysticercosis | Seizures | Yes | Ring-enhancing lesions | ELISA EITB | Seizures | Antihelminthic agents: praziquantel, albendazole |
| Agitation | Visualization of scolex in cystic structure | Psychosislike states | Steroids Anticonvulsants | |||
| Psychosis | Dementia | |||||
| Focal neurologic signs | ||||||
| Depression | ||||||
| Dementia | ||||||
|
| ||||||
| Neurosyphilis | General paresis | No | Lesions correlate to specific deficits | VDRL | Mood disorders | PCN |
| Psychosis | Rapid plasma regain | Psychosislike states | Ceftriaxone | |||
| Emotional lability | Fluorescent treponemal antibody-absorption assay | Behavioral changes: disinhibition | ||||
| Anhedonia | Lumbar puncture | Dementia | ||||
| Social withdrawal | ||||||
| Dementia | ||||||
|
| ||||||
| Creutzfeldt-Jakob disease | Rapidly progressive cognitive decline | No | Cortical ribboning | EEG: periodic sharp wave complexes | Rapidly progressive dementia | No effective treatment has been identified |
| Extrapyramidal signs, ataxia, myoclonus, dysphagia | Basal ganglia and cortical abnormalities | Tonsil biopsy for variant | Cerebellar signs | |||
| Akinetic mutism | Variant Creutzfeldt-Jakob disease: hyperintensity in pulvinar thalami | Creutzfeldt-Jakob disease | Visual signs | |||
| Agitation | 14-3-3 assay | Myoclonus | ||||
| Psychosis | Pyramidal symptoms | |||||
| Depression | Extrapyramidal symptoms | |||||
| Akinetic mutism | ||||||
| Mood disorders | ||||||
| Psychosislike states | ||||||
Abbreviations: ↑, increasing; Ab, antibody; CRP, C-reactive protein; CT, computed tomography; EEG, electroencephalogram; EITB, enzyme-linked immunoelectron-transfer; ELISA, enzyme-linked immunosorbent assay; ESR, erythrocytic sedimentation rate; HIV, human immunodeficiency virus; OCD, obsessive-compulsive disorder; PCN, penicillin; PCR, polymerase chain reaction; VDRL, Venereal Disease Research Laboratory.