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Instituto Nacional de Neurología y Neurocirugía

2009, Number 1

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Arch Neurocien 2009; 14 (1)

Electroencephalographic findings in patients with viral herpectic and nonherpetic encephalitis

Castro MJI, González-Aragón MF

Language: Spanish
References: 53
Page: 3-10
PDF size: 172.17 Kb.


ABSTRACT

Viral encephalitis is an acute infection of brain parenchyma. Diagnosis is based on clinical, laboratory and pathologic findings. Up to now there is no clear correlation between initial electroencephalographic findings and histopathology. Objective: to characterize electroencephalographic (EEG) patterns in patients with acute viral herpetic and non-herpetic encephalitis at hospital’s admission and 30 days later. Methods: 19 patients with a confirmed diagnosis of viral encephalitis where included in this descriptive study. A careful description of clinical manifestations, electroencephalographic findings and cerebrospinal fluid (CSF) analysis was performed. Polymerase chain reaction (PCR) in CSF was determined for herpes virus 1, 2 and 6. Results: CSF analysis was normal in 16 patients. We found herpetic ethiology in 6 patients (31.5%). In these, EEG findings were generalized theta rhythm in 33.33%, generalized theta-delta rhythm with epileptic focal activity (temporal) in 50% and frontal intermittent delta activity in 16.66%. In patients with non-herpetic encephalitis, generalized encephalopathic patterns with delta-theta rhythm and spikes and waves, were observed. In the temporal region in 4 patients and frontal in one; a case of epileptic status was determined. The 30 th day of illness evolution, we found the following findings: 14 patients had a normalized EEG pattern, 5 patients showed generalized delta-theta activity and another two had focal epileptic activity (frontal and temporal) as well. In this group we found a negative PCR in 3 patients. Conclusions: there is a clear relationship between abnormal EEG and clinical manifestations of viral encephalitis. EEG findings in acute stage of herpetic encephalitis showed several abnormalities in basal and interhemispheric cerebral activity concluding that there is no specific EEG pattern in viral herpetic or nonherpetic encephalitis.


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