Hokkanen L, Launes J, Poutiainen E, Valanne L, Salonen O, Sirén J, Iivanainen M
Department of Neurology, University of Helsinki, Finland.
J Neurol. 1997 Apr;244(4):239-45. doi: 10.1007/s004150050078.
Nine immunocompetent patients with acute herpes zoster encephalitis (HZE) were studied with the help of neurological investigations. All patients were treated with acyclovir. Neuropsychological performance was compared with that of a group of 16 healthy controls. Computed tomography of the head showed infarct-like hypodense lesions in two patients, involving the internal capsule in one case and the temporoparietal cortex and white matter in another. Hypoperfusion shown by single photon emission computed tomography, mostly involving the frontal areas bilaterally, was seen in six of the seven patients examined. Hyperperfusion as seen in herpes simplex encephalitis was not encountered. One patient remained mildly demented, but all the other patients recovered relatively well. Neuropsychological examination after acyclovir treatment showed a decline in memory and speed of cognitive processes, without circumscribed neuropsychological deficits. Six of the nine patients showed behavioural disinhibition, and mood changes were also observed. Memory impairment in HZE was not as global or as severe as is described after encephalitis due to herpes simplex virus. In HZE both the brain perfusion pattern and the neuropsychological test profile showed features compatible with subcortical dysfunction.
对9例免疫功能正常的急性带状疱疹性脑炎（HZE）患者进行了神经学检查。所有患者均接受阿昔洛韦治疗。将其神经心理学表现与16名健康对照者组成的一组进行比较。头部计算机断层扫描显示，2例患者有梗死样低密度病变，1例累及内囊，另1例累及颞顶叶皮质和白质。在接受检查的7例患者中，有6例单光子发射计算机断层扫描显示灌注不足，主要累及双侧额叶区域。未发现单纯疱疹性脑炎中所见的灌注过度情况。1例患者仍有轻度痴呆，但其他所有患者恢复相对良好。阿昔洛韦治疗后的神经心理学检查显示，记忆和认知过程速度下降，但无局限性神经心理学缺陷。9例患者中有6例表现出行为抑制解除，还观察到情绪变化。HZE中的记忆损害不像单纯疱疹病毒脑炎后所描述的那样全面或严重。在HZE中，脑灌注模式和神经心理学测试结果均显示出与皮质下功能障碍相符的特征。
