Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
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ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
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Advances in Clinical and Experimental Medicine

2015, vol. 24, nr 2, March-April, p. 361–371

doi: 10.17219/acem/40460

Publication type: review

Language: English

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Psychiatric Aspects of Herpes Simplex Encephalitis, Tick-Borne Encephalitis and Herpes Zoster Encephalitis Among Immunocompetent Patients

Magdalena Więdłocha1,A,B,C,D,F, Piotr Marcinowicz1,C,E,F,G, Bartłomiej Stańczykiewicz1,A,E,F

1 Division of Consultation Psychiatry and Neuroscience, Department of Psychiatry, Wroclaw Medical University, Poland

Abstract

The psychopathological symptoms occurring in the course of diseases associated with infections are often initially isolated and non-characteristic, and may cause diagnostic difficulties. Moreover, such disorders tend to be less responsive to psychiatric management. Among possible causes such as trauma, neoplasm and vascular changes, inflammatory changes of the brain as a result of a viral infection should also be considered. There were 452 registered cases of viral encephalitis in Poland in 2010, and although not very prevalent they remain a severe and lifethreatening condition. What is more, the frequently occurring neurological and psychiatric complications of viral encephalitis often result in permanent disabilities, causing a significant decrease in the quality of life. This article presents the three types of encephalitis that are most prevalent among immunocompetent patients in Poland, i.e. herpes simplex encephalitis (HSE), tick-borne encephalitis (TBE) and herpes zoster encephalitis (HZE). The psychopathology of the acute phase of the infection, the residual symptoms, features apparent in imaging studies and some neuropathological aspects are also presented. The paper also focuses on psychiatric aspects of the diagnostics and treatment of the described conditions. The clinical pictures of these infections are quite specific, although they cover a wide range of symptoms, and these characteristic features are described. The aim of this review is also to show the significance of thorough diagnostics and a multidisciplinary approach to patients with viral CNS infections.

Key words

herpes simplex encephalitis, varicella zoster encephalitis, tick-borne encephalitis, mental disorders.

References (46)

  1. Parda N, Polkowska A: Zapalenia opon mózgowo-rdzeniowych i zapalenia mózgu w Polsce w 2010 roku. Przegl Epidemiol 2012, 66, 221–228.
  2. Granerod J, Crowcroft NS: The epidemiology of acute encephalitis. Neuropsychol Rehabil 2007, 17, 406–428.
  3. Arciniegas DB, Anderson CA: Viral encephalitis: neuropsychiatric and neurobehavioral aspects. Curr Psychiatry Rep 2004, 6, 372–379.
  4. Pewter SM, Williams WH, Haslam C, Kay JM: Neuropsychological and psychiatric profiles in acute encephalitis in adults. Neuropsychol Rehabil 2007, 17, 478–505.
  5. David AS, Fleminger S, Kopelman MD, Lovestone S, Mellers JDC: Lishman’s Organic Psychiatry: A Textbook of Neuropsychiatry. Willey Blackwell, Oxford 2012, 4th ed., 434–438.
  6. Mumenthaler M, Mattle H: Neurology. Urban & Partner, Wrocław 2001, 3rd ed., 199–201.
  7. Hokkanen L, Launes J: Cognitive outcome in acute sporadic encephalitis. Neuropsychol Rev 2000, 10, 151–167.
  8. Kaiser R: Tick-borne encephalitis. Infect Dis Clin North Am 2008, 22, 561–575.
  9. Śpila B, Grzywa A, Helon B, Mikuła R: Paranoid syndrome and herpes simplex encephalitis – coincidence or casual nexus? Ann UMCS Sect D 2003, 58, 47–49.
  10. Zakrzewska B, Rowińska-Marcińska K, Kwieciński H, Guzek A, Strzelecki R, Przyjałkowski W, Lipowski D: Diagnostic difficulties in acute encephalitis with concurrent psychiatric disorders. Neur Neurochir Pol 1989, 23, 363–367.
  11. Koskiniemi M, Rantalaiho T, Piiparinen H, von Bonsdorff CH, Fakkila M, Jarvinen A, Koskiniemi S, Kinnunen E, Mannonen L, Muttilainen M, Linnavuory K, Porras J, Puolakkainen M, Raiha K, Salonen E, Ukkonen P, Vaheri A, Valtonen V: Infections of the central nervous system of suspected viral origin: a collaborative study from Finland. J Neurovirol 2001, 7, 400–408.
  12. Steiner I: Herpes simplex virus encephalitis: new infection or reactivation? Curr Opin Neurol 2011, 24, 268–274.
  13. Meyding-Lamadé U, Strank C: Herpesvirus infections of the central nervous system in immunocompromised patients. Ther Adv Neurol Disord 2012, 5, 279–296.
  14. Helon B, Mikuła R: Paranoid psychosis in the course of viral encephalitis – case study. Psychiatr Pol 2003, 37, 857–862.
  15. Kennedy P, Chaudhuri A: Herpes simplex encephalitis. J Neurol Neurosurg Psychiatry 2002, 73, 237–223.
  16. Telichowska A, Cedro A: Paranoid-catatonic syndrome in the course of viral encephalitis of Herpes Simplex etiology – a case with a favorable course. Wiad Psychiatr 2005, 8, 259–262.
  17. Steiner I, Kennedy PG, Pachner AR: The neurotropic herpes viruses: herpes simplex and varicella-zoster. Lancet Neurol 2007, 6, 1015–1028.
  18. Ghaziuddin M, Al-Khouri I, Ghaziuddin N: Autistic symptoms following herpes encephalitis. Eur Child Adolesc Psychiatry 2002, 11, 142–146.
  19. Baringer JR: Herpes simplex infections of the nervous system. Neurol Clin 2008, 26, 657–674.
  20. Łachut K, Ziółkowska-Kochan M, Kucharski R, Joachim K, Nowak M: Symptoms resembling frontotemporal dementia after an encephalitis of a probably herpes virus etiology – case study. Fam Med Primary Care Rev 2010, 12, 1099–1102.
  21. Skoldenberg B: Herpes simplex encephalitis. Scand J Infect Dis Suppl 1996, 100, 8–13.
  22. Hokkanen L, Launes J: Neuropsychological sequelae of acute-onset sporadic viral encephalitis. Neuropsychol Rehabil 2007, 17, 450–477.
  23. Hokkanen L, Launes J: Duration of transient amnesia correlates with cognitive outcome in acute encephalitis. Neuroreport 1997, 8, 2721–2725.
  24. McGrath N, Anderson NE, Croxson MC, Powell KF: Herpes simplex encephalitis treated with acyclovir: diagnosis and long term outcome. J Neurol Neurosurg Psychiatry 1997, 63, 321–326.
  25. Itzhaki RF, Lin WR, Shang D, Wilcock GK, Faragher B, Jamieson GA: Herpes simplex virus type 1 in brain and risk of Alzheimer’s disease. Lancet 1997, 349, 241–244.
  26. Kaiser R: Tick-borne encephalitis. Infect Dis Clin North Am 2008, 22, 561–575.
  27. Lindquist L, Vapalahti O: Tick-borne encephalitis. Lancet 2008, 31, 1861–1871.
  28. Walder G, Lkhamsuren E, Shagdar A, Bataa J, Batmunkh T, Orth D, Heinz FX, Danichova GA, Khasnatinov MA, Würzner R, Dierich MP: Serological evidence for tick-borne encephalitis, borreliosis, and human granulocytic anaplasmosis in Mongolia. Int J Med Microbiol 2006, 296, 69–75.
  29. Grzywa A, Karakuła H, Górecka J, Chuchura M: Delusional disorders (schizophrenia-like) in the course of tickborne encephalitis and borreliosis in a patient with type A hemophilia and post-traumatic epilepsy – diagnostic and therapeutic difficulties. Pol Merk Lek 2004, 16, 59–63.
  30. Juchnowicz D, Rudnik I, Czernikiewicz A, Zajkowska J, Pancewicz SA: Mental disorders occurring in the course of the Lyme disease and tick-borne encephalitis. Prz Epidemiol 2002, 56, Suppl.1, 37–50.
  31. Hermanowska-Szpakowicz T, Pancewicz S, Szulc A, Popławska R: Mental disorders as a consequence of tickborne encephalitis (TBE). Psychiatr Pol 1997, 31, 223–230.
  32. Fowler A, Forsman L, Eriksson M, Wiskström R: Tick-borne encephalitis carries a high risk of incomplete recovery in children. J Pediatr 2013, 163, 555–560.
  33. Bangen KJ, Delano-Wood L, Wierenga CE, Stricker NH, Hesselink JR, Bondi MW: Dementia following herpes zoster encephalitis. Clin Neuropsychol 2010, 24, 1193–1203.
  34. Amlie-Lefond C, Jubelt B: Neurologic manifestations of varicella zoster virus infections. Curr Neurol Neurosci Rep 2009, 9, 430–434.
  35. McKenna KF, Warneke LB: Encephalitis associated with herpes zoster: A case report and review. Can J Psychiatry 1992, 37, 271–273.
  36. Nagel MA, Cohrs RJ, Mahalingam R, Wellish MC, Forghani B, Schiller A, Safdieh JE, Kamenkovich E, Ostrow LW, Levy M, Greenberg B, Russman AN, Katzan I,Gardner CJ, Häusler M, Nau R, Saraya T, Wada H, Goto H, de Martino M, Ueno M, Brown WD, Terborg C, Gilden DH: The varicella zoster virus vasculopathies: clinical, CSF, imaging, and virologic features. Neurology 2008, 70, 853–860.
  37. Nagel MA, Forghani B, Mahalingam R, Wellish MC, Cohrs RJ, Russman AN, Katzan I, Lin R, Gardner CJ, Gilden DH: The value of detecting anti-VZV IgG antibody in CSF to diagnose VZV vasculopathy. Neurology 2007, 68, 1069–1073.
  38. Solomon T, Michael BD, Smith PE, Sanderson F, Davies NW, Hart IJ, Holland M, Easton A, Buckley C, Kneen R, Beeching NJ: National Encephalitis Guidelines Development and Stakeholder Groups: Management of suspected viral encephalitis in adults – Association of British Neurologists and British Infection Association National Guidelines. J Infect 2012, 64, 347–373.
  39. Solomon T, Hart IJ, Beeching NJ: Viral encephalitis: a clinician’s guide. Pract Neurol 2007, 7, 288–305.
  40. Venkatesan A, Tunkel AR, Bloch KC, Lauring AS, Sejvar J, Bitnun A, Stahl JP, Mailles A, Drebot M, Rupprecht CE, Yoder J, Cope JR, Wilson MR, Whitley RJ, Sullivan J, Granerod J, Jones C, Eastwood K, Ward KN, Durrheim DN, Solbrig MV, Guo-Dong L, Glaser CA: International Encephalitis Consortium. Case Definitions, Diagnostic Algorithms, And Priorities In Encephalitis: Consensus Statement Of The International Encephalitis Consortium. Clin Infect Dis 2013, 57, 1114–1128.
  41. Wilson BA: Neuropsychological rehabilitation: State of the science. S Afr J Psychology 2013, 43, 267–277.
  42. Wilson BA: Cutting Edge’ Developments in Neuropsychological Rehabilitation And Possible Future Directions. Brain Impairment 2011, 12, 33–42.
  43. Eatson A, Atkin K, Hare P: ‘A light in a very dark place’: The role of a voluntary organization providing support for those affected by encephalitis. Neuropsychol Rehabil 2007, 17, 638–647.
  44. Caroff SN, Mann SC, Gliatto MF, Sullivan KA, Campbell EC: Psychiatric manifestation of acute viral encephalitis. Psychiatric Annals 2001, 31, 193–204.
  45. Dowell E, Easton A, Solomon T: Consequences of encephalitis. Malton 2000, UK: Encephalitis Society.
  46. Coleman JL, Shukla D: Recent advances in vaccine development for herpes simplex virus types I and II. Hum Vaccin Immunother 2013, 26, 9.
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