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Predominant area of brain lesions in neonates with herpes simplex encephalitis

Journal of Perinatology volume 37, pages 1210–1214 (2017)Cite this article

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Abstract

Objective:

Nonspecific manifestations and a varied distribution of brain lesions can delay the diagnosis of herpes simplex encephalitis (HSE) in neonates. The aim of this study was to report predominant brain lesions in neonatal HSE, and then to investigate the association between pattern of predominant brain lesions, clinical variables and neurodevelopmental outcome.

Study Design:

A multicenter retrospective study was performed in neonates diagnosed with HSE between 2009 and 2014. Magnetic resonance (MR) images, including diffusion-weighted images, were obtained in the acute and chronic phase.

Results:

Three predominant areas of brain injury could be defined based on characteristic MRI findings in 10 of the 13 infants (77%). The inferior frontal/temporal pole area was involved in five (38%) patients. The watershed distribution was present in six (46%) patients. Four (31%) infants involved the corticospinal tract area. No significant association was found between any predominant distribution of brain lesion pattern and sex, country, viral type or viral load. However, the corticospinal tract involvement was significantly associated with motor impairment (P=0.045).

Conclusion:

Three predominant areas of brain lesion could be recognized in neonatal HSE. Recognition of those areas can improve prediction of neurodevelopmental outcome.

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Acknowledgements

We thank our infant patients and their families whose participation made this research possible. We also thank Dr Kubota, Dr Tsuji and Dr Ando for recruiting the patients and Dr Murk for the virological studies in Utrecht. All phases of this study were supported by a Grant-in-Aid for Scientific Research (C) (no. 26461543); Grants for Scientific Research on Innovative Areas (15H01578), from the Ministry of Education, Culture, Sports, Science and Technology in Japan.

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Authors and Affiliations

  1. Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan

    H Kidokoro, C Ogawa, Y Ito, A Ohno, Y Ito & J Natsume

  2. Department of Neonatology, University Medical Center Utrecht and Brain Center Rudolf Magnus, Utrecht, The Netherlands

    L S de Vries & F Groenendaal

  3. Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medicinal Sciences, Nagoya, Japan

    S Saitoh

  4. Department of Pediatrics, Aichi Medical University, Nagakute, Japan

    A Okumura

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  1. H Kidokoro
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  2. L S de Vries
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  3. C Ogawa
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  4. Y Ito
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  5. A Ohno
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  6. F Groenendaal
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  8. A Okumura
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  9. Y Ito
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  10. J Natsume
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Correspondence to H Kidokoro.

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The authors declare no conflict of interest.

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Supplementary Information accompanies the paper on the Journal of Perinatology website

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Kidokoro, H., de Vries, L., Ogawa, C. et al. Predominant area of brain lesions in neonates with herpes simplex encephalitis. J Perinatol 37, 1210–1214 (2017). https://doi.org/10.1038/jp.2017.114

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  • DOI: https://doi.org/10.1038/jp.2017.114

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