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Short communication| Volume 319, ISSUE 1-2, P156-157, August 15, 2012

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Enteroviral encephalitis presenting as rapidly progressive aphasia

      Abstract

      Enteroviral CNS infection is common and its clinical course is usually benign. In immunocompromised patients, however, it can cause meningoencephalitis, presenting with altered mentality and seizure. We describe a previously healthy female patient with enteroviral meningoencephalitis who showed rapidly progressive aphasia. Examination of her cerebrospinal fluid (CSF) showed pleocytosis with lymphocyte dominance, elevated protein, and normal glucose, findings compatible with viral encephalitis. Fluid-attenuated inversion recovery (FLAIR) brain MRI showed hyperintensity in the left frontal and parietal cortices. Enterovirus in the CSF was confirmed by reverse transcriptase-polymerase chain reaction (RT-PCR) of the CSF. Although her neurological deficits had progressed to global aphasia, conservative management resulted in complete improvement within 3 months. This case provides unusual clinical manifestations and imaging findings in enteroviral encephalitis.

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      References

        • Frantzidou F.
        • Kamaria F.
        • Dumaidi K.
        • Skoura L.
        • Antoniadis A.
        • Papa A.
        Aseptic meningitis and encephalitis because of herpesviruses and enteroviruses in an immunocompetent adult population.
        Eur J Neurol. 2008; 15: 995-997
        • Kupila L.
        • Vuorinen T.
        • Vainionpaa R.
        • Hukkanen V.
        • Marttila R.J.
        • Kotilainen P.
        Etiology of aseptic meningitis and encephalitis in an adult population.
        Neurology. 2006; 66: 75-80
        • Cree B.C.
        • Bernardini G.L.
        • Hays A.P.
        • Lowe G.
        A fatal case of coxsackievirus B4 meningoencephalitis.
        Arch Neurol. 2003; 60: 107-112
        • Modlin J.F.
        • Dagan R.
        • Berlin L.E.
        • Virshup D.M.
        • Yolken R.H.
        • Menegus M.
        Focal encephalitis with enterovirus infections.
        Pediatrics. 1991; 88: 841-845
        • Servais S.
        • Caers J.
        • Warling O.
        • et al.
        Enteroviral meningoencephalitis as complication of Rituximab therapy in a patient treated for diffuse large B-cell lymphoma.
        Br J Haematol. 2010; 150: 379-381
        • Valcour V.
        • Haman A.
        • Cornes S.
        • et al.
        A case of enteroviral meningoencephalitis presenting as rapidly progressive dementia.
        Nat Clin Pract Neurol. 2008; 4: 399-403
        • Liow K.
        • Spanaki M.V.
        • Boyer R.S.
        • Greenlee J.E.
        • Bale Jr., J.F.
        Bilateral hippocampal encephalitis caused by enteroviral infection.
        Pediatr Neurol. 1999; 21: 836-838
        • Endres A.S.
        • Helms T.
        • Steinfuhrer S.
        • Meisel H.
        Transient broca aphasia in an elderly man caused by coxsackievirus B5.
        J Neurol. 2002; 249: 1318-1319
        • Wakamoto H.
        • Ohta M.
        • Nakano N.
        • Kunisue K.
        SPECT in focal enterovirus encephalitis: evidence for local cerebral vasculitis.
        Pediatr Neurol. 2000; 23: 429-431
        • Warach S.
        • Latour L.L.
        Evidence of reperfusion injury, exacerbated by thrombolytic therapy, in human focal brain ischemia using a novel imaging marker of early blood–brain barrier disruption.
        Stroke. 2004; 35: 2659-2661
        • Parmar H.
        • Sitoh Y.Y.
        • Anand P.
        • Chua V.
        • Hui F.
        Contrast-enhanced flair imaging in the evaluation of infectious leptomeningeal diseases.
        Eur J Radiol. 2006; 58: 89-95
        • Kremer S.
        • Abu Eid M.
        • Bierry G.
        • et al.
        Accuracy of delayed post-contrast FLAIR MR imaging for the diagnosis of leptomeningeal infectious or tumoral diseases.
        J Neuroradiol. 2006; 33: 285-291