Department of Radiology, Duke University Medical Center, Durham, North Carolina 27710, USA.
Pediatr Neurol. 2010 Jan;42(1):32-9. doi: 10.1016/j.pediatrneurol.2009.07.014.
We sought to distinguish patients testing positive for human herpesvirus 6 from those testing negative, based on clinical features and magnetic resonance images. Sixteen immunosuppresed patients were tested by polymerase chain reaction for human herpes virus 6 DNA in cerebrospinal fluid (nine positive results). Medical records were examined for agitation, altered mental status, hallucinations, insomnia, memory loss, and seizures. Patients were sorted by viral status. Clinical features were compared with imaging findings. Insomnia, agitation, and hallucinations were preferentially evident in human herpes virus 6-positive patients. Imaging abnormalities were evident in the hippocampus of both groups. However, extrahippocampal involvement was more common in human herpes virus 6-positive patients and among those with insomnia and hallucinations or seizures. Patients with memory loss and imaging abnormalities in the entorhinal cortex or amygdala were likely to test positive, as were patients with hallucinations and abnormal magnetic resonance signal in the hippocampus. Human herpes virus 6 encephalitis patients present with diverse clinical features that are also common among patients who test negative. This entity should be suspected in patients who present with insomnia, seizures, or hallucinations when imaging abnormalities are evident in the hippocampus, amygdala, and limbic structures beyond the medial temporal lobe.
我们试图根据临床特征和磁共振图像将人类疱疹病毒 6 检测呈阳性的患者与检测呈阴性的患者区分开来。通过聚合酶链反应对 16 名免疫抑制患者的脑脊液进行了人类疱疹病毒 6 DNA 检测（9 个阳性结果）。检查了病历以确定是否存在激动、精神状态改变、幻觉、失眠、记忆力减退和癫痫。根据病毒状况对患者进行分类。比较了临床特征和影像学发现。失眠、激动和幻觉在人类疱疹病毒 6 阳性患者中更为明显。两组患者的海马体均存在影像学异常。然而，人类疱疹病毒 6 阳性患者以及存在失眠、幻觉或癫痫的患者中，海马体以外的受累更为常见。存在记忆力减退和内嗅皮层或杏仁核影像学异常的患者可能呈阳性，存在幻觉和海马体磁共振信号异常的患者也是如此。人类疱疹病毒 6 脑炎患者表现出多种临床特征，这些特征在检测呈阴性的患者中也很常见。当海马体、杏仁核和内侧颞叶以外的边缘结构存在影像学异常时，伴有失眠、癫痫或幻觉的患者应怀疑存在这种疾病。
