acyclovir and Lymphocytosis

BACKGROUND Acute cerebellitis in adults is a rare disease. The etiology is unknown but postulated to be due to primary infection or para-infection. Different presentations have been reported, which complicates the diagnosis process. CASE REPORT We report the case of a young man who presented with headache, vomiting, and vertigo. He was found to have ataxia and cerebellar signs, bradycardia magnetic resonance imaging (MRI) of the brain showed acute cerebellitis, and cerebrospinal fluid (CSF) studies showed lymphocytosis. Further investigations showed the presence of Epstein-Barr virus (EBV) immunoglobulin M (IgM) and IgG. His symptoms resolved completely with corticosteroid and antiviral treatments. CONCLUSIONS Acute cerebellitis can present in various ways. Bradycardia, along with neurological deficits, should raise the suspicion of acute cerebellitis.

Topics: Acute Disease; Acyclovir; Anti-Bacterial Agents; Anti-Inflammatory Agents; Antiviral Agents; Ataxia; Bradycardia; Ceftriaxone; Cerebellar Diseases; Dexamethasone; Epstein-Barr Virus Infections; Glucocorticoids; Humans; Immunoglobulin G; Immunoglobulin M; Lymphocytosis; Male; Young Adult

HaNDL (transient headache and neurological deficits with cerebrospinal fluid lymphocytosis) syndrome is an infrequent condition included at group 7 "headache attributed to non-vascular intracranial disorder" in the recent International Classification of Headache Disorders (ICHD-3), code 7.3.5. The description states "migraine-like headache episodes (typically 1-12) accompanied by neurological deficits including hemiparaesthesia, hemiparesis and/or dysphasia, but positive visual symptoms only uncommonly, lasting several hours. There is lymphocytic pleocytosis. The disorder resolves spontaneously within 3 months". In this description confusional state is not considered as a main symptom, even if in the literature this aspect is frequently reported. Here, we report the cases of two young boys presenting with confusional state as the main complaint. The possible pathogenesis of the different clinical presentation is discussed.

Topics: Acyclovir; Adolescent; Ceftriaxone; Confusion; Headache; Humans; Lymphocytosis; Male; Nervous System Diseases; Young Adult

Topics: Acyclovir; Adrenal Cortex Hormones; Adult; Anti-Inflammatory Agents; Antigens, CD; Antiviral Agents; Endophthalmitis; Herpes Zoster; Herpesvirus 3, Human; Humans; Immunophenotyping; Lymphocytosis; Male; Retina; T-Lymphocytes; Vitrectomy; Vitreous Body

Pseudomigraine with temporary neurological symptoms and lymphocytic pleocytosis is a rare syndrome resolving within less than 3 months.. A young 17-year-old woman without previous medical history was admitted to the hospital because of right motor weakness and language disturbances. The symptoms resolved in a few hours and were followed by severe left headaches with important vegetative signs. Several similar episodes were noted in the previous 10 days. Cranial MRI was normal. EEG showed important slowing of the cerebral electrogenesis. More than 250 lymphocytic cells were found at CSF analysis. Outcome was spontaneously favorable, without similar symptoms after 6-month follow-up.. Pseudomigraine with lymphocytic pleocytosis seems to be a particular syndrome of unknown origin. This is an elimination diagnosis, generally with a benign course.

Topics: Acyclovir; Adolescent; Antiviral Agents; Brain; Cognition Disorders; Diagnosis, Differential; Electroencephalography; Female; Humans; Lymphocytosis; Magnetic Resonance Imaging; Migraine Disorders

We describe a patient who developed a severe but temporally limited retrograde amnesia coupled with a relatively mild anterograde amnesia following herpes simplex encephalitis. The patient showed a profound retrograde amnesia for autobiographical events extending for about 10 years prior to the disease onset. Her knowledge about public events and famous persons was also impaired for this period. An MRI and SPECT demonstrated bilateral medial temporal pathology. This case represents a further instance of a relatively focal retrograde amnesia following brain damage. We review other reported cases with focal retrograde amnesia and consider theoretical and neuroanatomical accounts for the present case. Two factors may account for her amnesic patterns: a partial disruption of the store for premorbid binding codes (i.e., information that multimodal feature representations occurred synchronously); along with a relative preservation of the encoding process required to develop new synchronous codes.

Topics: Acyclovir; Amnesia, Retrograde; Antibodies, Viral; Antiviral Agents; Electroencephalography; Encephalitis, Herpes Simplex; Epilepsy, Generalized; Female; Herpesvirus 1, Human; Hippocampus; Humans; Infusions, Intravenous; Lymphocytosis; Magnetic Resonance Imaging; Middle Aged; Neuropsychological Tests; Radiography; Severity of Illness Index; Temporal Lobe; Time Factors; Tomography, Emission-Computed, Single-Photon