Emergency Neurology by Unknown

Author:Unknown
Language: eng
Format: epub
ISBN: 9783030757786
Publisher: Springer International Publishing

JC Virus

In progressive multifocal leukoencephalopathy , there are one or more nonenhancing subcortical white matter hyperintensities on T2 and FLAIR sequences.

Spinal Fluid Analysis

The characteristic findings on lumbar puncture in viral encephalitis are an increased opening pressure, a lymphocytic pleocytosis, a mild to moderate increase in the protein concentration, and a normal (or rarely mildly decreased) glucose concentration. Virus-specific IgM antibodies and PCR are both recommended. There are both CSF multiplex PCR assays and specific viral pathogen PCRs. The CSF multiplex PCR assays typically test for herpes simplex virus-1, herpes simplex virus-2, enteroviruses, human herpesvirus-6, cytomegalovirus, and varicella zoster virus. Approximately 10 ccs of CSF should be saved for future testing. This may be necessary if the CSF multiplex assay fails to detect the nucleic acid of the suspected virus based on clinical presentation and neuroimaging, and further testing for a specific viral PCR would be useful, and/or CSF is needed for metagenomic next-generation sequencing to aid with diagnosis.

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