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Cited by 224Infectious Encephalopathies and EncephalitisHerpesvirus Infections and TreatmentsAutoimmune Neurological Disorders and Treatments

The DOI matches its Crossref record; 36 of the 39 references it cites were found in a registry or an index.

Herpes simplex encephalitis: long term magnetic resonance imaging and neuropsychological profile.

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Kapur, N, Barker, S, Burrows, E H, Ellison, D, Brice, J, Illis, L S, Scholey, K, Colbourn, C, Wilson, B, Loates, M·1994·Journal of Neurology, Neurosurgery & Psychiatry
DOI 10.1136/jnnp.57.11.1334PMC PMC1073183
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Abstract

The first comprehensive in vivo documentation of the long term profile of pathological and spared tissue is described in a group of 10 patients with a diagnosis of herpes simplex encephalitis, who were left with memory difficulties as a major residual sequel of their condition. With a dedicated MRI protocol, which included high resolution images of temporal lobe and limbic system areas, data are provided on structures that have recently gained importance as anatomical substrates for amnesia. The major features of the lesion profile were: (1) unilateral or bilateral hippocampal damage never occurred in isolation, and was often accompanied by damage to the parahippocampus, the amygdala, specific temporal lobe gyri, and the temporal poles; (2) the insula was always abnormal; (3) neocortical temporal lobe damage was usually unilateral or asymmetric. It never occurred in isolation, and was invariably associated with more medial pathological changes; (4) anterior and inferior temporal lobe gyri were damaged more often and more severely than posterior and superior temporal lobe gyri; (5) pronounced abnormality was often present in the substantia innominata (region of the basal forebrain/anterior perforated substance); (6) there was evidence of significant abnormality in the fornix; (7) there was evidence of damage to the mammillary bodies; (8) thalamic nuclei were affected in around 50% of cases, with damage usually unilateral; (9) frontal lobe damage was present in a few patients, and affected medial areas more than dorsolateral areas; (10) there was some involvement of the striatum, although this was usually unilateral and mild; (11) there was usually limited involvement of the cingulate gyrus and of the parietal and occipital lobes; (12) the cerebellum and brain stem were never damaged. Lesion covariance analysis indicated a close relation between the presence of abnormalities in temporal lobe and limbic-diencephalic regions. Unlike severe head injury, lesions in the temporal pole were not associated with the presence of lesions in the orbitofrontal cortex. Long term neuropsychological impairments were characterised by a dense amnesia in 60% of cases, and a less serve but noticeable anterograde memory impairment in the others. Naming and problem solving deficits were found in a small number of cases. Only two patients were able to return to open employment. Severity of amnesia showed a significant relation with severity of damage to medical limbic system structures such as the hippocampus, with bilateral damage being particularly important. By contrast, there was a minimal relation between memory loss and severity of damage to the thalamus, to lateral temporal lobe areas, or to the frontal lobes.

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Research works printed but not linked: 2

  1. Laurent B, Allegri RF, Michel D, et al. Encephalites herpetiques a predominance unilaterale etude neuropsychologique au long cours de 9 cas. Rev Neurol (Paris) 1990;146:671-81.
  2. Milner B. Hippocampal-neocortical interactions in human memory processes. Discussions in Neuroscience 1990;6: 101-8.

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Metadata

Authors
Kapur, N., Barker, S., Burrows, E. H., Ellison, D., Brice, J., Illis, L. S., Scholey, K., Colbourn, C., Wilson, B., & Loates, M.
ORCID
Venue
Journal of Neurology, Neurosurgery & Psychiatry
Publisher
BMJ
Published
1994-11-01
Volume
57
Issue
11
Pages
1334-1342
ISSN
0022-3050 (ISSN-L)
DOI
10.1136/jnnp.57.11.1334
PMC
PMC1073183
OpenAlex
W1989487775
Cited by
224
References
39
Citations by year
2026: 4 · 2025: 2 · 2024: 5 · 2023: 4 · 2022: 4 · 2021: 11 · 2020: 4 · 2019: 6 · 2018: 4 · 2017: 6 · 2016: 3 · 2015: 8 · 2014: 14 · 2013: 10 · 2012: 8
FWCI
5.22
Type
journal article
Language
en
Open access
Locations
  • Journal of Neurology Neurosurgery & Psychiatry (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Infectious Diseases › Infectious Encephalopathies and Encephalitis
  • Health Sciences › Medicine › Infectious Diseases › Herpesvirus Infections and Treatments
  • Health Sciences › Medicine › Clinical Neurology › Autoimmune Neurological Disorders and Treatments
Keywords
herpes simplex encephalitis, amnesia, anterograde amnesia, temporal lobe lesions, hippocampal lesions, limbic system, fornix, temporal pole, neuropsychological outcomes, residual cognitive impairment, return to work, naming deficits, problem-solving deficits, orbitofrontal cortex
MeSH terms
Adult, Aged, Brain, Female, Humans, Limbic System, Magnetic Resonance Imaging, Male, Memory Disorders, Middle Aged, Neuropsychological Tests, Substantia Innominata, Temporal Lobe, Thalamus, Wechsler Scales, Simplexvirus, Encephalitis, Viral

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