BRAIN and NERVE－神経研究の進歩67巻7号

2015年07月発行

増大特集 神経疾患と感染症update

単純ヘルペス脳炎update

著者： 黒田宙¹

所属機関： ¹東北大学神経内科

ページ範囲：P.931 - P.939

文献概要

単純ヘルペス脳炎（HSE）は単純ヘルペスウイルス（HSV）により引き起こされ，高い死亡率と後遺症発生率を示す神経救急疾患である。本稿では，HSE病態への宿主免疫反応の関与，注意すべき鑑別疾患である自己免疫性辺縁系脳炎，HSE診断における髄液中HSV-DNA検査と抗体検査の位置づけ，基本治療であるアシクロビルの投与法および中止の目安について，近年の進歩を踏まえて概説した。

参考文献

1) 日本神経感染症学会（編): ヘルペス脳炎——診療ガイドラインに基づく診断基準と治療方針. 中山書店, 東京, 2007

2) Tunkel AR, Glaser CA, Bloch KC, Sejvar JJ, Marra CM, et al: The management of encephalitis: clinical practice guidelines by the Infectious Diseases Society of America. Clin Infect Dis 47: 303-327, 2008

3) Solomon T, Hart IJ, Beeching NJ: Viral encephalitis: a clinician's guide. Pract Neurol 7: 288-305, 2007

4) Solomon T, Michael BD, Smith PE, Sanderson F, Davies NW, et al: Management of suspected viral encephalitis in adults-Association of British Neurologists and British Infection Association National Guidelines. J Infect 64: 347-373, 2012

5) Hjalmarsson A, Blomqvist P, Sköldenberg B: Herpes simplex encephalitis in Sweden, 1990-2001: incidence, morbidity, and mortality. Clin Infect Dis 45: 875-880, 2007

6) Whitley RJ: Viral encephalitis. N Engl J Med 323: 242-250, 1990

7) Levitz RE: Herpes simplex encephalitis: a review. Heart Lung 27: 209-212, 1998

8) Corey L, Whitley RJ, Stone EF, Mohan K: Difference between herpes simplex virus type 1 and type 2 neonatal encephalitis in neurological outcome. Lancet 1: 1-4, 1988

9) Zhang SY, Jouanguy E, Sancho-Shimizu V, von Bernuth H, Yang K, et al: Human Toll-like receptor-dependent induction of interferons in protective immunity to viruses. Immunol Rev 220: 225-236, 2007

10) Casrouge A, Zhang SY, Eidenschenk C, Jouanguy E, Puel A, et al: Herpes simplex virus encephalitis in human UNC-93B deficiency. Science 314: 308-312, 2006

11) Zhang SY, Jouanguy E, Ugolini S, Smahi A, Elain G, et al: TLR3 deficiency in patients with herpes simplex encephalitis. Science 317: 1522-1527, 2007

12) Wildemann B, Ehrhart K, Storch-Hagenlocher B, Meyding-Lamadé U, Steinvorth S, et al: Quantitation of herpes simplex virus type 1 DNA in cells of cerebrospinal fluid of patients with herpes simplex virus encephalitis. Neurology 48: 1341-1346, 1997

13) Kamei S, Takasu T, Morishima T, Mizutani T: Serial changes of intrathecal viral loads evaluated by chemiluminescence assay and nested PCR with aciclovir treatment in herpes simplex virus encephalitis. Intern Med 43: 796-801, 2004

14) Pepose JS, Hilborne LH, Cancilla PA, Foos RY: Concurrent herpes simplex and cytomegalovirus retinitis and encephalitis in the acquired immune deficiency syndrome (AIDS). Ophthalmology 91: 1669-1677, 1984

15) Fine AJ, Sorbello A, Kortepeter C, Scarazzini L: Central nervous system herpes simplex and varicella zoster virus infections in natalizumab-treated patients. Clin Infect Dis 57: 849-852, 2013

16) Bradford RD, Pettit AC, Wright PW, Mulligan MJ, Moreland LW, et al: Herpes simplex encephalitis during treatment with tumor necrosis factor-alpha inhibitors. Clin Infect Dis 49: 924-927, 2009

17) Prüss H, Finke C, Höltje M, Hofmann J, Klingbeil C, et al: N-methyl-D-aspartate receptor antibodies in herpes simplex encephalitis. Ann Neurol 72: 902-911, 2012

18) Dalmau J, Lancaster E, Martinez-Hernandez E, Rosenfeld MR, Balice-Gordon R: Clinical experience and laboratory investigations in patients with anti-NMDAR encephalitis. Lancet Neurol 10: 63-74, 2011

19) Tyler KL, Tedder DG, Yamamoto LJ, Klapper JA, Ashley R, et al: Recurrent brainstem encephalitis associated with herpes simplex virus type 1 DNA in cerebrospinal fluid. Neurology 45: 2246-2250, 1995

20) Razavi B, Razavi M: Herpes simplex encephalitis-an atypical case. Infection 29: 357-358, 2001

21) Hatipoglu HG, Sakman B, Yuksel E: Magnetic resonance and diffusion-weighted imaging findings of herpes simplex encephalitis. Herpes 15: 13-17, 2008

22) Heiner L, Demaerel P: Diffusion-weighted MR imaging findings in a patient with herpes simplex encephalitis. Eur J Radiol 45: 195-198, 2003

23) Küker W, Nägele T, Schmidt F, Heckl S, Herrlinger U: Diffusion-weighted MRI in herpes simplex encephalitis: a report of three cases. Neuroradiology 46: 122-125, 2004

24) Oyanguren B, Sánchez V, González FJ, de Felipe A, Esteban L, et al: Limbic encephalitis: a clinical-radiological comparison between herpetic and autoimmune etiologies. Eur J Neurol 20: 1566-1570, 2013

25) Launes J, Nikkinen P, Lindroth L, Brownell AL, Liewendahl K, et al: Diagnosis of acute herpes simplex encephalitis by brain perfusion single photon emission computed tomography. Lancet 1: 1188-1191, 1988

26) Lai M, Huijbers MG, Lancaster E, Graus F, Bataller L, et al: Investigation of LGI1 as the antigen in limbic encephalitis previously attributed to potassium channels: a case series. Lancet Neurol 9: 776-785, 2010

27) DeBiasi RL, Kleinschmidt-DeMasters BK, Weinberg A, Tyler KL: Use of PCR for the diagnosis of herpesvirus infections of the central nervous system. J Clin Virol 25 (Suppl 1): S5-S11, 2002

28) Nahmias AJ, Whitley RJ, Visintine AN, Takei Y, Alford CA Jr: Herpes simplex virus encephalitis: laboratory evaluations and their diagnostic significance. J Infect Dis 145: 829-836, 1982

29) Lakeman FD, Koga J, Whitley RJ: Detection of antigen to herpes simplex virus in cerebrospinal fluid from patients with herpes simplex encephalitis. J Infect Dis 155: 1172-1178, 1987

30) Soong SJ, Watson NE, Caddell GR, Alford CA Jr, Whitley RJ: Use of brain biopsy for diagnostic evaluation of patients with suspected herpes simplex encephalitis: a statistical model and its clinical implications. NIAID Collaborative Antiviral Study Group. J Infect Dis 163: 17-22, 1991

31) Whitley RJ, Alford CA, Hirsch MS, Schooley RT, Luby JP, et al: Vidarabine versus acyclovir therapy in herpes simplex encephalitis. N Engl J Med 314: 144-149, 1986

32) Sköldenberg B, Forsgren M, Alestig K, Bergström T, Burman L, et al: Acyclovir versus vidarabine in herpes simplex encephalitis. Randomised multicentre study in consecutive Swedish patients. Lancet 2: 707-711, 1984

33) Gordon B, Selnes OA, Hart J Jr, Hanley DF, Whitley RJ: Long-term cognitive sequelae of acyclovir-treated herpes simplex encephalitis. Arch Neurol 47: 646-647, 1990

34) VanLandingham KE, Marsteller HB, Ross GW, Hayden FG: Relapse of herpes simplex encephalitis after conventional acyclovir therapy. JAMA 259: 1051-1053, 1988

35) De Tiège X, Rozenberg F, Des Portes V, Lobut JB, Lebon P, et al: Herpes simplex encephalitis relapses in children: differentiation of two neurologic entities. Neurology 61: 241-243, 2003

36) Valencia I, Miles DK, Melvin J, Khurana D, Kothare S, et al: Relapse of herpes encephalitis after acyclovir therapy: report of two new cases and review of the literature. Neuropediatrics 35: 371-376, 2004

37) Pouplin T, Pouplin JN, Van Toi P, Lindegardh N, Rogier van Doorn H, et al: Valacyclovir for herpes simplex encephalitis. Antimicrob Agents Chemother 55: 3624-3626, 2011

38) Kamei S, Sekizawa T, Shiota H, Mizutani T, Itoyama Y, et al: Evaluation of combination therapy using aciclovir and corticosteroid in adult patients with herpes simplex virus encephalitis. J Neurol Neurosurg Psychiatry 76: 1544-1549, 2005

39) Martinez-Torres F, Menon S, Pritsch M, Victor N, Jenetzky E, et al: Protocol for German trial of Acyclovir and corticosteroids in Herpes-simplex-virus-encephalitis (GACHE): a multicenter, multinational, randomized, double-blind, placebo-controlled German, Austrian and Dutch trial ［ISRCTN45122933］. BMC Neurol 8: 40, 2008

40) Raschilas F, Wolff M, Delatour F, Chaffaut C, De Broucker T, et al: Outcome of and prognostic factors for herpes simplex encephalitis in adult patients: results of a multicenter study. Clin Infect Dis 35: 254-260, 2002