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Slow Infections of the Central Nervous System

Published online by Cambridge University Press:  15 November 2018

Laurence E. Becker
Laurence E. Becker*
Affiliation:
Department of Pathology, University of Toronto
*
Neuropathologist, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, M5G 1L5, Canada
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Summary

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This review describes the recent advances in slow infections of the nervous system emphasizing the pathogenetic aspects of these diseases. A theoretical model for the pathogenesis of subacute sclerosing panencephalitis (SSPE) is proposed, illustrating the factors that may affect host response to the measles virus and allow it to persist and produce the panencephalitis. The isolation of an oncogenic virus from progressive multifocal leukoencephalopathy (PML) has implications in the consideration of a viral etiology for some brain tumors. The agent responsible for the transmissibility of kuru and Creutzfeldt-Jakob disease (CJD) remains uncharacterized despite recent interest in viroids and abnormalities in replication of cell membranes. The epidemiological data on multiple sclerosis suggests an exposure to an infectious agent at an early age of life modified by the host response. No specific agent has been consistently associated with multiple sclerosis. Amyotrophic lateral sclerosis (ALS), Parkinson’s disease, Mollare’s meningitis and Behcet’s disease are other examples where a virus is suspect but unproven. The ability of viruses to persist in the host for months to years has linked many chronic neurologic diseases to an infectious agent, enlarging the spectrum of disease caused by viruses.

Résumé

Résumé

Cette revue décrit les récents développements au sujet des infections lentes du systéme nerveux, et insiste sur les aspects pathogénétiques de ces maladies. Un modèle théorique pour la pathogénèse de la panencéphalite sclérosante subaigue (SSPE) est proposé illustrant les facteurs pouvant influencer la réponse de l’hôte au virus de la rougeole et lui permettre de persister et de produire la panencéphalite. L’isolation d’ un virus oncogéne d’une leukoencéphalopathie multifocale progressive (PML) a des implications dans la considération de l’étiologie virale de certaines tumeurs du cerveau. L’agent responsable de la transmissibilité du kuru et de la maladie de Jakob-Creutzfeldt {CJD) demeure non caractérisée en dépit d’un intérêt récent pour les viroîdes et les anomalies de la “replication” des membranes cullulaires. Les données épidémiologiques sur la sclérose en plaques suggèrent une exposition à un agent infectieux dès le jeune âge modifié par la réponse de l’hôte. Pas d’agent spécifique n’a été associé de façon constante à la sclérose en plaques. La sclérose latérale amyotrophique (ALS), la maladie de Parkinson, la méningite de Mollaret et la maladie de Behcet sont d’autres exemples où la présence d’un virus est suspecte mais non prouvée. Labilite des virus à demeurer chez l’hôte pendant des mois et des années nous permet de lier plusieurs maladies neurologiques chroniques à un agent infectieux, élargissant ainsi le spectre des maladies causées par des virus.

Type
Recent Progress
Information
Canadian Journal of Neurological Sciences , Volume 4 , Issue 2 , May 1977 , pp. 81 - 88
Copyright
Copyright © Canadian Neurological Sciences Federation 1977

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