Department of Neurology, Chung-Ang University College of Medicine, Seoul, South Korea.
J Neurol Sci. 2012 Aug 15;319(1-2):156-7. doi: 10.1016/j.jns.2012.05.006. Epub 2012 May 24.
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.
肠道病毒中枢神经系统感染很常见，其临床病程通常为良性。然而，在免疫功能低下的患者中，它可引起脑膜脑炎，表现为精神状态改变和癫痫发作。我们描述了一例先前健康的女性肠道病毒脑膜脑炎患者，其表现为进行性快速失语症。对其脑脊液（CSF）的检查显示淋巴细胞优势的白细胞增多、蛋白升高和正常的葡萄糖，这些发现与病毒性脑炎相符。液体衰减反转恢复（FLAIR）脑 MRI 显示左额顶皮质高信号。通过 CSF 的逆转录聚合酶链反应（RT-PCR）确认 CSF 中的肠道病毒。尽管她的神经功能缺损已进展为完全性失语症，但保守治疗在 3 个月内完全恢复。该病例提供了肠道病毒性脑炎的不常见临床表现和影像学发现。
