Clinical cases of chronic reactivated HHV-6- and HHV-7-infection with temporal mesial sclerosis and personality changes

Abstract

У пациентов с хроническимиреактивованимиHHV‑ 6 — и HHV‑7‑инфекциями нередко развиваются расстройства психики с изменением личности. Data from a systematic review and meta‑analysis of randomized controlled clinical trials published in 2018, prepared by Wipfler P. et al., confirm the association of HHV‑6 and temporal mesial sclerosis in humans. The evidence base for the involvement of herpesviruses in the development of temporal mesial sclerosis is based on the following points: regular development of temporal mesial sclerosis after temporal or limbic encephalitis of herpesvirus etiology, the presence of DNA, RNA, virus proteins and free virion viruses in the neurodegenerative zone, detection of correlation between viral protein expression and glutamatergic excitotoxicity processes in the lesion area, reproduction temporal mesial sclerosis with epileptic syndrome in experimental animals during herpesvirus infection and elucidation of the mechanism of transolfactor migration of herpesviruses from the upper respiratory tract to the neurons of the hippocampus and amygdala of the temporal lobes of the brain.Patients with chronic reagents of HHV‑6 and HHV‑7 infections often experience mental disorders with personality changes. A 2018 systematic review and meta‑analysis of controlled clinical trials by P. Wipfler et al. confirm the association of herpes simplex virus type 6 infection with temporal median sclerosis in humans. The evidence base for the involvement of herpes viruses in the development of temporal median sclerosis is based on the following facts: regular development of temporal median sclerosis after temporal and limbic herpes virus encephalitis, the presence of DNA, RNA, virus proteins and free virions in the neurodegeneration zone, discovery of a number of mechanisms of virus‑induced neurodegeneration, and epilepsy between the expression of viral proteins and the processes of glutamatergic excitotoxicity in the affected area, reproduction of temporal median sclerosis with epileptic syndrome in experimental animals with experimental infection with herpes viruses and elucidation of the mechanism of transolfactor migration of herpes viruses from the upper respiratory tract to the neurons of the hippocampus and amygdala of the temporal lobes of the cerebral hemispheres.Two clinical cases of the development of temporal median sclerosis with psychosomatic, psychotic, epileptic, autonomic, cognitive and fibromyalgic manifestations in immunocompromised patients with primary minor immunodeficiencies during reactivation of herpes viruses type 6 and 7 are presented. These cases from practice make it possible to demonstrate the algorithm of diagnostic search and therapeutic interventions in a virus‑induced neurodegenerative process with damage to the mesolimbic structures of the temporal lobes of the brain.