Autism Studies and Related Medical Conditions, January 2009 - TACA

199. Stubbs EG et al. Autism and congenital cytomegalovirus. J Autism Dev Disord.
1984 Jun;14(2):183-9. PMID: 6086566
200. Ivarsson SA et al. Autism as one of several disabilities in two children with
congenital cytomegalovirus infection. Neuropediatrics. 1990 May;21(2):102-3. PMID:
2163029
201. McLachlan RS et al. Treatment of Rasmussen's syndrome with ganciclovir.
Neurology. 1996 Oct;47(4):925-8. PMID: 8857720
"Since cytomegalovirus (CMV) has been implicated in the pathogenesis of Rasmussen's
syndrome, we treated four patients with ganciclovir, a potent anti-CMV drug. A 7-yearold
girl with seizures escalating to 60/day over 3 months despite triple antiepileptic drug
therapy became seizure-free 5 days after initiation of treatment with no recurrence at
1.5 years follow-up. Focal neurologic signs, cognitive function, and the EEG returned to
normal. Two patients treated 34 and 72 months after disease onset in association with
epilepsy surgery had a reduction in seizures and one had no response. CMV genome
was detected in the brains of two of the three patients in whom it was assessed. The
response to antiviral therapy supports a viral etiology for chronic encephalitis of
Rasmussen. If the disease is suspected, treatment with ganciclovir should be
considered as early as possible.
202. Domachowske JB et al. Acute manifestations and neurologic sequelae of Epstein-
Barr virus encephalitis in children. Pediatr Infect Dis J. 1996 Oct;15(10):871-5. PMID:
8895918
BACKGROUND: Complications of Epstein-Barr virus (EBV) infection are diverse and
include a number of neurologic manifestations such as meningitis, meningoencephalitis,
cerebellitis, cranial neuritis and others. In general encephalitis caused by EBV in
pediatric patients has been considered a self-limited illness with few or no sequelae.
METHODS: Charts were reviewed from all patients < 18 years of age admitted to or
discharged from the State University of New York Health Science Center at Syracuse
between 1982 and 1992 with a diagnosis of encephalitis or meningo- encephalitis.
Eleven cases of EBV encephalitis diagnosed during a 10-year period were reviewed to
characterize the clinical and laboratory findings in the acute setting and the extent of
neurologic sequelae on follow-up. RESULTS: Acute neurologic manifestations were
diverse and included combative behavior (55%), seizures (36%), headache (36%) and
evidence of focal involvement (27%). Classic findings of infectious mononucleosis were
noted infrequently; 18% each had pharyngitis, adenopathy, positive heterophile
antibody tests or atypical lymphocytosis. Two patients (18%) had abnormal
neuroimaging studies, one in the acute stage and the other at the time of follow-up.
Seven patients (64%) had abnormal electroencephalograms (EEGs) in the acute
setting; of these three had persistent abnormalities on follow-up. Forty percent
developed persistent neurologic abnormalities including global impairment,
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