Inclusion Body Encephalitis

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Abstract
A 20-year-old white male became acutely ill on June 22, 1953, with headache and fever followed by delirium, and comatose state on the 3rd day. This state was maintained for 4 months, after which he began to improve, so that 2 years after onset he was mentally alert, amnesic for the illness, anosognosic, disoriented to time and place, emotionally labile, with poor retention, He responded appropriately and without aphasia to questions; he had left homonomous hemianopsia, paraplegia and marked weakness of left upper limb. Sensation and head functions were intact. He is subject to grand mal fits. This status remained unchanged over the following year. The spinal fluid, characterized at onset by 488 white cells (65% mononuclear) and sterile to culture and mouse inoculation, has become a cellular but protein is still elevated. Brain biopsy on day 5 of illness revealed an acute encephalitis with Cowdry type A eosinophilic intranuclear inclusion bodies in neurones and neuroglia. Based on this case and others reported, it is suggested that inclusion body encephalitis be divided into (1) Dawson''s encephalitis and (2) herpes simplex encephalitis; with differentiation solely on ability to isolate the virus of herpes simplex. The use of the generic term is to be restricted to those cases in which such isolation was not attempted.