Clinical Neurovirology

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This comprehensive reference analyzes the basic science, clinical features, imaging, pathology, and treatment of specific viral entities affecting the central nervous system (CNS)—assisting professionals in their attempt to identify, examine, and manage viral CNS infections and unravel the therapeutic and diagnostic challenges associated with viral CNS disorders including HIV infection, West Nile encephalitis, and Creuzfeldt-Jacob disease.

Author(s): Avindra Nath, Joseph R. Berger
Series: Neurological Disease and Therapy
Edition: 1
Publisher: Informa Healthcare
Year: 2003

Language: English
Pages: 661

Clinical Neurovirology......Page 2
Foreword......Page 9
Preface......Page 11
Contents......Page 13
Contributors......Page 17
General Nature of Viruses......Page 21
Table of Contents......Page 0
Virus Morphology......Page 22
Capsid Morphology......Page 25
Classification Schemes......Page 26
Integration of Classification Schemes......Page 29
The Viral Growth Curve......Page 30
Steps in Viral Replication......Page 32
Cell Tropism......Page 37
ACKNOWLEDGMENTS......Page 38
REFERENCES......Page 39
TRANSMISSION OF VIRUSES......Page 41
Transneuronal Spread......Page 43
CELL TYPES INFECTED AND REPLICATION IN THE BRAIN......Page 44
BRAIN DEFENSE MECHANISMS......Page 45
Interferons......Page 46
Humoral Immune Responses......Page 47
Chemokines......Page 48
Bystander Effect......Page 49
Autoimmune Responses......Page 50
REFERENCES......Page 51
INTRODUCTION......Page 55
IMMUNODEFICIENCY VIRUS INFECTION......Page 56
STEREOTACTIC NEUROSURGICAL PROCEDURE......Page 58
REFERENCES......Page 60
BACKGROUND......Page 62
Lumbar Puncture......Page 63
NONVIROLOGICAL CSF ANALYSES......Page 65
CSF Protein......Page 66
Total and Differential White Blood Cell Count......Page 68
VIRUS ISOLATION IN CSF......Page 69
Methods......Page 70
Clinical Applications......Page 71
Clinical Applications......Page 74
MOLECULAR TECHNIQUES......Page 75
Methods......Page 76
Clinical Applications......Page 88
Practical Considerations......Page 93
Postamplification Analysis......Page 95
Methods......Page 100
Clinical Applications......Page 103
SUMMARY......Page 104
REFERENCES......Page 105
INTRODUCTION......Page 128
Epidemiology and Pathogenesis......Page 129
Differential Diagnosis......Page 130
Auxiliary Studies......Page 131
Therapy......Page 132
NEONATAL HSV-2 ENCEPHALITIS......Page 133
MYELORADICULITIS......Page 134
Primary and Reactivated Infection......Page 135
LATENT HSV-1 INFECTION......Page 136
THE POTENTIAL USE OF HERPES VECTORS FOR GENE THERAPY TO THE NERVOUS SYSTEM......Page 138
REFERENCES......Page 140
NATURALLY OCCURRING VARICELLA: CLINICAL AND EPIDEMIOLOGICAL FEATURES......Page 148
Molecular......Page 149
PATHOLOGY AND PATHOGENESIS......Page 150
ZOSTER (RADICULONEUROPATHY, SHINGLES, GANGLIONITIS)......Page 151
ZOSTER PARESIS......Page 152
Zoster Large-Vessel Encephalitis (Granulomatous Arteritis)......Page 153
VZV MYELITIS......Page 155
REYE’S SYNDROME......Page 156
PREHERPETIC NEURALGIA......Page 157
OTHER NON-ZOSTERIFORM VZV INFECTION OF THE NERVOUS SYSTEM WITHOUT RASH......Page 158
DIAGNOSIS OF VZV INFECTION: AMPLIFIABLE VZV DNA BY PCR AND ANTIBODY TO VZV......Page 159
TREATMENT......Page 160
Prevalence, Distribution, Extent, and Configuration of VZV DNA in Human Ganglia......Page 161
THE VARICELLA VACCINE: CONCERNS REGARDING REACTIVATION FROM LATENCY......Page 162
REFERENCES......Page 163
HISTORY......Page 173
THE VIRUS......Page 174
EBV-RELATED DISEASES AND BASIC PATHOGENESIS......Page 175
DIAGNOSIS OF ACUTE EBV INFECTION......Page 176
EBV-RELATED NEUROLOGICAL DISEASES......Page 177
EBV Encephalitis......Page 178
Guillain-Barre ´ Syndrome and Other Forms of Peripheral Neuropathy......Page 179
Cranial Nerve Palsy......Page 180
Cerebellar Ataxia......Page 181
Psychiatric Manifestations and the Alice-in-Wonderland Syndrome......Page 182
Primary CNS Lymphoma......Page 183
Lymphoproliferative Disease......Page 185
TREATMENT......Page 186
REFERENCES......Page 190
BACKGROUND......Page 195
Lumbar Puncture......Page 196
NONVIROLOGICAL CSF ANALYSES......Page 198
CSF Protein......Page 199
Total and Differential White Blood Cell Count......Page 201
VIRUS ISOLATION IN CSF......Page 202
Methods......Page 203
Clinical Applications......Page 204
Clinical Applications......Page 207
MOLECULAR TECHNIQUES......Page 208
Methods......Page 209
Clinical Applications......Page 221
Practical Considerations......Page 226
Postamplification Analysis......Page 228
Methods......Page 233
Clinical Applications......Page 236
SUMMARY......Page 237
REFERENCES......Page 238
INTRODUCTION......Page 260
Tropism......Page 261
Roseola......Page 262
HHV-6-Associated Encephalitis......Page 263
HHV-6 Association with Multiple Sclerosis......Page 264
CONCLUSION......Page 269
REFERENCES......Page 271
INTRODUCTION......Page 276
Biology of JC Virus......Page 277
Molecular Control of JCV Gene Expression......Page 279
Molecular Interactions Between JCV and HIV-1......Page 280
ASSOCIATION WITH AIDS......Page 282
EPIDEMIOLOGY OF JCV INFECTION......Page 283
Clinical Epidemiology in the Era of AIDS......Page 284
CLINICAL FEATURES......Page 286
LABORATORY STUDIES......Page 287
PATHOLOGY......Page 289
TREATMENT......Page 291
REFERENCES......Page 292
HIV: STRUCTURE AND REPLICATION......Page 303
Pathogenesis......Page 304
Mechanism......Page 305
Diagnostic Studies......Page 306
Epidemiology......Page 307
Clinical Findings......Page 308
Radiological Findings......Page 309
Treatment......Page 312
REFERENCES......Page 319
Clinical Features......Page 329
Electrophysiological Data......Page 330
Pathogenesis......Page 331
Treatment......Page 332
Distal Symmetrical Polyneuropathy......Page 333
Inflammatory Demyelinating Polyneuropathy......Page 336
Progressive Polyradiculopathy......Page 338
Clinical Features......Page 340
Pathology and Pathogenesis......Page 341
REFERENCES......Page 342
HTLV-I......Page 349
ADULT T-CELL LEUKEMIA (ATL)......Page 350
Histopathological Features of HAM/TSP......Page 351
Pathological Mechanisms......Page 354
REFERENCES......Page 356
HISTORY......Page 360
EPIDEMIOLOGY......Page 361
PATHOPHYSIOLOGY......Page 362
Incubation period......Page 366
Acute Neurological Phase......Page 367
LABORATORY FINDINGS......Page 369
DIFFERENTIAL DIAGNOSIS......Page 370
ESTABLISHING THE DIAGNOSIS......Page 371
MANAGEMENT......Page 372
PREVENTION......Page 373
ACKNOWLEDGMENTS......Page 374
REFERENCES......Page 375
INTRODUCTION......Page 377
THE VIRUSES......Page 378
NORTH AMERICAN ARBOVIRAL ENCEPHALITIDES......Page 379
Eastern Equine Encephalitis......Page 380
Western Equine Encephalitis......Page 381
St. Louis Encephalitis......Page 383
West Nile Virus Encephalitis......Page 385
La Crosse Virus Encephalitis......Page 387
Powassan Virus Encephalitis......Page 388
INTERNATIONAL ARBOVIRAL ENCEPHALIDITES......Page 389
Venezuelan Equine Encephalitis......Page 390
Tick-Borne Encephalitis......Page 391
Japanese Encephalitis......Page 394
Murray Valley Encephalitis......Page 396
Rift Valley Fever......Page 398
CONCLUDING REMARKS: REPRISE, RESOURCES, AND NEEDS......Page 400
REFERENCES......Page 401
Classification......Page 408
Epidemiology......Page 409
Systemic Pathogenesis......Page 410
Viral (Aseptic) Meningitis......Page 413
Encephalitis......Page 415
Rhombencephalitis......Page 416
Paralytic Disease......Page 417
Persistent Infections......Page 420
DIAGNOSIS......Page 421
REFERENCES......Page 422
DESCRIPTION AND CLASSIFICATION OF ADENOVIRUSES......Page 427
DESCRIPTION OF ILLNESSES CAUSED BY ADENOVIRUS......Page 428
HISTORY OF THE ILLNESS......Page 430
EPIDEMIOLOGY......Page 431
PATHOPHYSIOLOGY......Page 432
NEUROLOGICAL MANIFESTATIONS OF ADENOVIRAL INFECTION......Page 433
Viral Antigen Assays......Page 441
Polymerase Chain Reaction......Page 442
Serology......Page 443
REFERENCES......Page 444
INTRODUCTION......Page 449
VIRUS FAMILY, STRUCTURE, AND REPLICATION......Page 450
Epidemiology......Page 453
Clinical Manifestations......Page 454
Pathophysiology......Page 455
Diagnostic Strategies......Page 458
Treatment and Prevention......Page 459
Clinical Manifestations......Page 460
Pathophysiology......Page 462
CSF Findings......Page 465
Diagnostic Strategies......Page 466
Treatment and Prevention......Page 467
Pathophysiology......Page 468
Diagnostic Strategies......Page 469
REFERENCES......Page 470
Classification......Page 479
Viral Replication......Page 480
Morbidity and Mortality......Page 481
PATHOGENESIS......Page 482
Central Nervous System......Page 484
Viral Culture......Page 486
Polymerase Chain Reaction......Page 487
Control......Page 488
REFERENCES......Page 489
DESCRIPTION OF THE VIRUS......Page 494
Congenital Rubella......Page 495
Rubella Encephalitis......Page 496
REFERENCES......Page 497
ILLNESS......Page 500
HISTORY OF THE ILLNESS......Page 502
CLINICAL MANIFESTATIONS......Page 503
RADIOGRAPHIC AND NEUROPHYSIOLOGICAL FINDINGS......Page 506
CEREBROSPINAL FLUID FINDINGS......Page 508
TREATMENT......Page 510
REFERENCES......Page 511
INTRODUCTION......Page 516
Viral Attachment and Entry......Page 517
Viral Replication and Release......Page 519
Dengue Serotypes......Page 520
Dengue Vectors......Page 521
Early History......Page 522
The Dengue Encephalopathy Controversy......Page 523
EPIDEMIOLOGY OF NEUROLOGICAL DENGUE......Page 524
Other Risk Factors for Neurological Dengue......Page 525
Antibody-Dependent Enhancement......Page 528
PATHOPHYSIOLOGY OF NEUROLOGICAL COMPLICATIONS......Page 530
Other Metabolic Abnormalities......Page 531
Viral Invasion Across the Blood-Brain Barrier and Encephalitis......Page 532
Virulence Determinants......Page 534
Dengue Hemorrhagic Fever......Page 535
Classification of Neurological Dengue......Page 537
Cerebral Dengue......Page 538
Reduced Level of Consciousness......Page 539
Peripheral Neuropathies and Myelopathies......Page 541
Outcome of Neurological Complications......Page 544
DIAGNOSIS......Page 546
Dengue Fever and DHF......Page 549
Neurological Dengue......Page 551
Dengue Vaccines......Page 552
REFERENCES......Page 553
DIFFERENTIAL DIAGNOSIS FROM JAPANESE ENCEPHALITIS......Page 564
CLINICAL MANIFESTATIONS......Page 565
TREATMENT......Page 566
RELAPSE AND LATE-ONSET NIPAH ENCEPHALITIS......Page 567
REFERENCES......Page 568
INTRODUCTION......Page 570
HISTORY......Page 571
TRANSMISSION......Page 572
THE AGENT......Page 573
CLINICAL ILLNESS......Page 574
THE CHRONIC PHASE......Page 577
PATHOLOGY......Page 580
PROGNOSIS......Page 582
TREATMENT......Page 583
REFERENCES......Page 584
INTRODUCTION......Page 590
EPIDEMIOLOGY......Page 592
Neuropathology......Page 593
Transmission and Pathogenesis of TSEs......Page 595
Clinical Spectrum of Human Prion Diseases......Page 598
Variant CJD......Page 600
Genetically Defined Prion Diseases......Page 601
DIFFERENTIAL DIAGNOSIS......Page 605
Neurophysiological and Radiographic Findings......Page 606
CSF Findings......Page 608
DIAGNOSTIC STRATEGY......Page 610
GLOSSARY......Page 611
REFERENCES......Page 612
Structure and Infectivity......Page 619
Polyoma Tumorigenesis......Page 620
Epidemiology of Brain Tumors......Page 622
Ependymoma......Page 623
Choroid Plexus Tumors......Page 627
Medulloblastoma/Primitive Neuroectodermal Tumor......Page 629
REFERENCES......Page 632
HISTORICAL PERSPECTIVE......Page 639
The National Childhood Vaccine Injury Act......Page 640
The Guillain-Barre ´ Syndrome......Page 641
Hepatitis B Vaccine......Page 642
Measles, Mumps, and Rubella Vaccines......Page 643
Varicella......Page 645
Smallpox (Variola) Vaccine......Page 646
REFERENCES......Page 647
ANTIRETROVIRAL AGENTS FOR HIV INFECTION......Page 649
Acyclovir......Page 650
Gancyclovir......Page 653
Famciclovir......Page 654
Cidofovir......Page 655
Foscarnet......Page 656
INTERFERONS......Page 657
REFERENCES......Page 658