Non-herpetic Acute Limbic Encephalitis : Cerebrospinal Fluid Cytokines and Magnetic Resonance Imaging Findings

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概要

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•   Objective  Non-herpetic acute limbic encephalitis (non-herpetic ALE) is regarded as a new subgroup of limbic encephalitis. In the present study, clinical findings and cerebrospinal fluid (CSF) cytokines in patients with non-herpetic ALE were investigated.  Patients and Methods  For adult inpatients in our hospital and related hospitals from 1996 to 2001, non-herpetic ALE was examined according to the criteria described in this study. Six patients were diagnosed as having non-herpetic ALE, and their clinical data and magnetic resonance imaging (MRI) were analyzed. In the CSF samples of the 6 patients with non-herpetic ALE and 6 patients with herpes simplex encephalitis (HSE), the concentrations of tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-6, and interferon (IFN)-γ were determined using sandwich-type enzyme-linked immunosorbent assay (ELISA) kits.  Results  The six patients with non-herpetic ALE showed all the acute encephalitis features, such as fever, altered consciousness, seizures, memory impairment, and mild CSF pleocytosis. MRI demonstrated selective abnormal signals in the limbic system, including the bilateral hippocampi and amygdalae. The levels of CSF IL-6 and IFN-γ in patients with non-herpetic ALE were significantly lower than those in patients with HSE (p<0.05 and p<0.01, respectively). The levels of both TNF-α and IL-1β were below the detection limits in both groups.  Conclusion  Six patients were newly diagnosed as having non-herpetic ALE in this study. These patients revealed both acute limbic encephalitis and MRI abnormalities in the bilateral hippocampi and amygdalae. The levels of IL-6 and IFN-γ in the CSF of patients with non-herpetic ALE were significantly lower than those of patients with HSE, possibly reflecting an immunological process in this type of ALE rather than direct viral infection.

• 社団法人　日本内科学会の論文
• 2004-01-01

著者

• ABE Toshi

  Department of Radiology, Kurume University School of Medicine

• Ichiyama Takashi

  Department of Pediatrics, Yamaguchi University School of Medicine

• Ichiyama Takashi

  Department Of Pediatrics Yamaguchi University Graduate School Of Medicine

• Ichiyama Takashi

  Department Of Pediatrics Yamaguchi University School Of Medicine

• Ayabe Mitsuyoshi

  The First Department Of Internal Medicine Kurume University School Of Medicine

• Ayabe Mitsuyoshi

  First Department Of Medicine Kurume University School Of Medicine

• ASAOKA Kyoko

  the First Department of Internal Medicine, Kurume University School of Medicine

• SHOJI Hiroshi

  the First Department of Internal Medicine, Kurume University School of Medicine

• SHOJI Hiroshi

  First Department (Neurology) of Internal Medicine, Kurume University School of Medicine

• ASAOKA Kyoko

  First Department of Internal Medicine Kurume University School of Medicine

• NISHIZAKA Shinya

  First Department of Internal Medicine Kurume University School of Medicine

• OHORI Nobuhira

  Department of Neurology, Yamaguchi Red Cross Hospital

• EIZURU Yoshito

  Division of Persistent & Oncogenic Viruses, Center for Chronic Disease, Faculty of Medicine, Kagoshi

• Abe Toshi

  Department Of Radilogy School Of Medicine Kurume University

• Asaoka Kyoko

  The First Department Of Internal Medicine Kurume University School Of Medicine

• Ohori Nobuhira

  Department Of Neurology Yamaguchi Red Cross Hospital

• Eizuru Yoshito

  Division Of Oncogenic And Persistent Viruses Center For Chronic Viral Diseases Kagoshima University

• Ichiyama Takashi

  Department Of Pediatrics Graduate School Of Medicine Yamaguchi University

• Shoji Hiroshi

  First Department Of Internal Medicine Kurume University School Of Medicine

• Ayabe Mitsuyoshi

  First Department Of Internal Medicine Kurume University School Of Medicine

• Shoji Hiroshi

  First Department (neurology) Of Internal Medicine Kurume University School Of Medicine

• ABE Toshi

  Department Radiology, Kurume University School of Medicine

• AYABE Mitsuyoshi

  First Department (Neurology) of Internal Medicine, Kurume University School of Medicine

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