Tag: post-viral syndrome

Neuropsychiatric sequelae of Nipah virus encephalitis

Abstract:

The authors followed nine patients with Nipah virus encephalitis over the course of 24 months. Eight of the nine developed psychiatric features assigned to the encephalitis. Three patients developed major depressive disorder immediately after recovering from the encephalitis, and two developed depression approximately 1 year after the outbreak. Two patients developed personality changes, and two suffered chronic fatigue syndrome.

Neuropsychological testing was accomplished in eight of the nine patients. Deficits in attention, verbal, and/or visual memory were substantial in seven of the eight patients tested. Verbal memory was more impaired than visual memory in these patients. Comparison between psychiatric and cognitive impairment and total number of brain lesions showed no discernible trends.

 

Source: Ng BY, Lim CC, Yeoh A, Lee WL. Neuropsychiatric sequelae of Nipah virus encephalitis. J Neuropsychiatry Clin Neurosci. 2004 Fall;16(4):500-4. http://www.ncbi.nlm.nih.gov/pubmed/15616178

 

Recovery from infectious mononucleosis: a case for more than symptomatic therapy? A systematic review

Abstract:

Infectious mononucleosis is usually an acute, transiently incapacitating condition, but for some sufferers it precipitates chronic illness. It is unclear which patients are at risk of a prolonged state of illness following onset of infectious mononucleosis and if there are any useful preventive measures that would facilitate recovery. The aim of this study was to review all cohort studies and intervention trials that provide information on: (a) the longitudinal course of ill health subsequent to the onset of infectious mononucleosis; (b) the relationship between psychosocial and clinical factors and recovery rate; and (c) the effect of interventions on recovery.

A systematic review was conducted, based on a search of the PSYCHINFO, MEDLINE, EMBASE and CINHAL databases up to October 2001, and ISI Science and Social Sciences Citation Indices up to 22 November 2001. Eight papers were identified that gave data on illness following onset of infectious mononucleosis. The best evidence concluded that there is a distinct fatigue syndrome after infectious mononucleosis. Eight papers explored risk factors for prolonged illness following acute infectious mononucleosis.

Results varied on the association of acute illness characteristics and psychological features with prolonged ill health. Poor physical functioning, namely lengthy convalescence and being less fit or active, consistently predicted chronic ill health. Three trials reported on interventions that aimed to shorten the time taken to resolve symptoms after uncomplicated infectious mononucleosis. None of the drug trials found any evidence that drug therapy shortens recovery time. The trial that compared the effect of activity with imposed bed rest, found that those patients allowed out of bed as soon as they felt able reported a quicker recovery. More information is needed on the course of ill health subsequent to the onset of infectious mononucleosis. Certain risk factors associated with delay may be amenable to a simple intervention in primary care.

 

Source: Candy B, Chalder T, Cleare AJ, Wessely S, White PD, Hotopf M. Recovery from infectious mononucleosis: a case for more than symptomatic therapy? A systematic review. Br J Gen Pract. 2002 Oct;52(483):844-51. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1316091/ (Full article)

 

The chronic fatigue syndrome

Abstract:

The chronic fatigue syndrome (CFS) including myalgic encephalomyelitis and the postviral syndrome is a term used today to describe a not fully recognized disease characterized primarily by chronic or recurrent debilitating fatigue and various combinations of neuromuscular and neuropsychological symptoms. The term CFS has been introduced and defined by the Centers for Disease Control (CDC) in Atlanta. Fatigue is one of the most common symptoms in medicine, but CFS as defined by CDC has appeared to be quite rare in the general population. Researchers have suggested that the syndrome is a heterogenous immunologic disorder that follows viral infection, but despite numerous studies on the subject the etiologic factor of the syndrome is unknown. CFS is a controversial diagnosis. In a very high percentage of patients with the CFS depression, phobias or anxiety disorders have frequently preceded the onset of the chronic fatigue. There are many overlapping symptoms between CFS and major depression. Some clinicians suggest that it is not obvious that CFS can be distinguished from neurasthenia.

 

Source: Białyszewski A. [The chronic fatigue syndrome]. Psychiatr Pol. 1993 Nov-Dec;27(6):601-11 [Article in Polish] http://www.ncbi.nlm.nih.gov/pubmed/8134494

 

Postviral syndrome

Note: This comment appeared in the Journal of the Royal Society of Medicine, Volume 83, October 1990 in reference to The diagnosis of postviral syndrome. [J R Soc Med. 1990]

 

Postviral syndrome Dr D J D Perrins writes (June 1990 JRSM, p 413) of the difficulty in making a definitive diagnosis of postviral syndrome (myalgic encephalomyelitis, ME) echoing the paper by Dr Bowman et aL (December 1988 JRSM, p 712) and goes on to affirm ‘the clinical pattern of ME has much in common with multiple sclerosis (1). No neurologist of experience would agree with this statement. Dr Perrins admits that some of the patients he himself reported upon may in fact have had MS. Seven out of 10 MS patients will tell you the diagnosis if you listen carefully (the late Henry Miller); ‘a blind neurologist is better than a deaf one’ (Mumenthaler, Berne). The clinical course of ME and MS is usually quite different, though occasional ‘difficult’ similarities may be met with.

You can read the rest of this comment here: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1292897/pdf/jrsocmed00131-0089b.pdf

 

Source:  E. J. Field. Postviral syndrome. J R Soc Med. 1990 Oct;83(10):675-6. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1292897/