{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T06:51:25Z","timestamp":1787899885069,"version":"build-2784847793"},"reference-count":37,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2020,10,13]],"date-time":"2020-10-13T00:00:00Z","timestamp":1602547200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,10,13]],"date-time":"2020-10-13T00:00:00Z","timestamp":1602547200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100000853","name":"University of Glasgow","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100000853","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Neurol"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Several viruses have the capacity to cause serious infections of the nervous system in patients who are immunosuppressed. Individuals may be immunosuppressed because of primary inherited immunodeficiency, secondary immunodeficiency due to particular diseases such as malignancy, administration of immunosuppressant drugs or organ or bone marrow transplantation. The viruses capable of such opportunistic infection of the nervous system include herpes simplex virus (HSV), Varicella-Zoster virus (VZV), Cytomegalovirus (CMV), Epstein \u2013Barr virus (EBV), Human Herpes virus type 6 (HHV-6), JC virus (JCV), enterovirus, measles virus and Covid-19. In most cases it seems likely that immunological defence mechanisms in the immunosuppressed are deficient which creates a suitable environment for certain viruses to become opportunistic in the nervous and other systems. Further research is required both to understand these opportunistic mechanisms in more detail and also to determine how many virus infections are modified by specific inborn errors of immunological responses.<\/jats:p>","DOI":"10.1007\/s00415-020-10265-z","type":"journal-article","created":{"date-parts":[[2020,10,13]],"date-time":"2020-10-13T16:08:54Z","timestamp":1602605334000},"page":"3026-3030","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["An overview of viral infections of the nervous system in the immunosuppressed"],"prefix":"10.1007","volume":"268","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8420-8583","authenticated-orcid":false,"given":"Peter G. E.","family":"Kennedy","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,10,13]]},"reference":[{"key":"10265_CR1","doi-asserted-by":"publisher","DOI":"10.1007\/s13365-020-00857-w","author":"PGE Kennedy","year":"2020","unstructured":"Kennedy PGE, Mogensen TH (2020) J Determinants of neurological syndromes caused by varicella zoster virus (VZV). J Neurovirol. https:\/\/doi.org\/10.1007\/s13365-020-00857-w ((Online ahead of print))","journal-title":"J Neurovirol"},{"key":"10265_CR2","first-page":"57","volume-title":"Neurologic complications in organ transplant recipients","author":"EFM Wijdicks","year":"1999","unstructured":"Wijdicks EFM (1999) Neurologic complications in transplant recipients: a bird\u2019s eye view. In: Wijdicks EFM (ed) Neurologic complications in organ transplant recipients. Butterworth and Co (Publishers) Ltd, Great Britain, pp 57\u201362"},{"key":"10265_CR3","first-page":"141","volume-title":"Neurologic complications in organ transplant recipients","author":"NE Tolkoff-Rubin","year":"1999","unstructured":"Tolkoff-Rubin NE, Kees Hovingh G, Rubin RH (1999) Central nervous system Infections. In: Wijdicks EFM (ed) Neurologic complications in organ transplant recipients. Butterworth and Co (Publishers) Ltd, Great Britain, pp 141\u2013168"},{"issue":"Pt7","key":"10265_CR4","doi-asserted-by":"publisher","first-page":"1581","DOI":"10.1099\/vir.0.000128","volume":"96","author":"PGE Kennedy","year":"2015","unstructured":"Kennedy PGE, Rovnak J, Badani H, Cohrs RJ (2015) A comparison of herpes simplex virus type 1 and varicella-zoster virus latency and reactivation. J Gen Virol 96(Pt7):1581\u20131602. https:\/\/doi.org\/10.1099\/vir.0.000128","journal-title":"J Gen Virol"},{"key":"10265_CR5","doi-asserted-by":"publisher","first-page":"15016","DOI":"10.1038\/nrdp.2015.16","volume":"1","author":"AA Gershon","year":"2015","unstructured":"Gershon AA, Breuer J, Cohen JI, Cohrs RJ, Gershon MD, Gilden D, Grose C, Hambleton S, Kennedy PGE, Oxman MN, Seward JF, Yamanishi K (2015) Varicella-Zoster virus infection. Nat Rev Dis Primers 1:15016. https:\/\/doi.org\/10.1038\/nrdp.2015.16","journal-title":"Nat Rev Dis Primers"},{"issue":"11","key":"10265_CR6","doi-asserted-by":"publisher","first-page":"609","DOI":"10.3390\/v10110609","volume":"10","author":"PGE Kennedy","year":"2018","unstructured":"Kennedy PGE, Gershon AA (2018) Clinical Features of Varicella-Zoster Virus. Infec Virus 10(11):609. https:\/\/doi.org\/10.3390\/v10110609","journal-title":"Infec Virus"},{"key":"10265_CR7","doi-asserted-by":"publisher","first-page":"577","DOI":"10.1111\/j.1468-1331.2004.00867.x","volume":"9","author":"M Brainin","year":"2004","unstructured":"Brainin M, Barnes M, Baron JC, Gilhus NE, Hughes R, Selmaj K, Waldemar G (2004) Guidance for the preparation of neurological management guidelines by EFNS scientific task forces\u2013revised recommendations. Eur J Neurol 9:577\u2013581. https:\/\/doi.org\/10.1111\/j.1468-1331.2004.00867.x","journal-title":"Eur J Neurol"},{"issue":"5","key":"10265_CR8","doi-asserted-by":"publisher","first-page":"331","DOI":"10.1111\/j.1468-1331.2005.01126.x","volume":"12","author":"I Steiner","year":"2010","unstructured":"Steiner I, Budka H, Chaudhuri A, Koskiniemi M, Sainio K, Salonen O, Kennedy PGE (2010) Viral meningoencephalitis: a review of diagnostic methods and guidelines for management. Eur J Neurol 12(5):331\u2013343. https:\/\/doi.org\/10.1111\/j.1468-1331.2005.01126.x","journal-title":"Eur J Neurol"},{"issue":"10","key":"10265_CR9","doi-asserted-by":"publisher","first-page":"1278","DOI":"10.1111\/j.1468-1331.2012.03808.x","volume":"19","author":"I Steiner","year":"2012","unstructured":"Steiner I, Schmutzhard E, Sellner J, Chaudhuri A, Kennedy PG (2012) EFNS-ENS guidelines for the use of PCR technology for the diagnosis of infections of the nervous system. Eur J Neurol 19(10):1278\u20131291. https:\/\/doi.org\/10.1111\/j.1468-1331.2012.03808.x","journal-title":"Eur J Neurol"},{"key":"10265_CR10","doi-asserted-by":"publisher","first-page":"1015","DOI":"10.1016\/S1474-4422(07)70267-3","volume":"6","author":"I Steiner","year":"2007","unstructured":"Steiner I, Kennedy PGE, Pachner AR (2007) The neurotropic herpes viruses: herpes simplex and varicella-zoster. Lancet Neurol 6:1015\u20131028","journal-title":"Lancet Neurol"},{"key":"10265_CR11","doi-asserted-by":"publisher","first-page":"i10","DOI":"10.1136\/jnnp.2003.034280","volume":"75","author":"PGE Kennedy","year":"2004","unstructured":"Kennedy PGE (2004) Viral encephalitis: causes, differential diagnosis, and management. J Neurol Neurosurg Psychiat 75:i10\u2013i15. https:\/\/doi.org\/10.1136\/jnnp.2003.034280 ((suppl))","journal-title":"J Neurol Neurosurg Psychiat"},{"key":"10265_CR12","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1016\/j.coi.2020.01.004","volume":"62","author":"E Jouanguy","year":"2020","unstructured":"Jouanguy E, B\u00e9ziat V, Mogensen TH, Casanova JL, Tangye SG, Zhang SY (2020) Human inborn errors of immunity to herpes viruses. Curr Opin Immunol 62:106\u2013122. https:\/\/doi.org\/10.1016\/j.coi.2020.01.004 (Epub 2020 Jan)","journal-title":"Curr Opin Immunol"},{"issue":"21","key":"10265_CR13","doi-asserted-by":"publisher","first-page":"1888","DOI":"10.1212\/WNL.0000000000000999","volume":"83","author":"HK Lim","year":"2014","unstructured":"Lim HK, Sepp\u00e4nen M, Hautala T, Ciancanelli MJ, Itan Y, Lafaille FG, e al, (2014) TLR3 deficiency in herpes simplex encephalitis: high allelic heterogeneity and recurrence risk. Neurology 83(21):1888\u20131897. https:\/\/doi.org\/10.1212\/WNL.0000000000000999 (Epub 2014 Oct 22)","journal-title":"Neurology"},{"key":"10265_CR14","doi-asserted-by":"crossref","unstructured":"Gilden DH and Tyler KL (2005) Herpesvirus infection and peripheral neuropathy. In peripheral neuropathy 4th edition. Editors PJ Dyck and PK Thomas, Elsevier Saunders, USA Chapter 93 2117\u20132128","DOI":"10.1016\/B978-0-7216-9491-7.50096-X"},{"issue":"2","key":"10265_CR15","doi-asserted-by":"publisher","first-page":"554","DOI":"10.1212\/wnl.51.2.554","volume":"51","author":"PA Fodor","year":"1998","unstructured":"Fodor PA, Levin MJ, Weinberg A, Sandberg E, Sylman J, Tyler KL (1998) Atypical herpes simplex virus encephalitis diagnosed by PCR amplification of viral DNA from CSF. Neurology 51(2):554\u2013559. https:\/\/doi.org\/10.1212\/wnl.51.2.554","journal-title":"Neurology"},{"key":"10265_CR16","doi-asserted-by":"publisher","first-page":"530","DOI":"10.1002\/ana.410350505","volume":"35","author":"DH Gilden","year":"1994","unstructured":"Gilden DH, Wright RR, Schneck SA, Gwaltney JM Jr, Mahalingam R (1994) Zoster sine herpete, a clinical variant. Ann Neurol 35:530\u2013533","journal-title":"Ann Neurol"},{"key":"10265_CR17","doi-asserted-by":"publisher","first-page":"416","DOI":"10.1212\/WNL.0b013e31820a0d5d","volume":"76","author":"PGE Kennedy","year":"2011","unstructured":"Kennedy PGE (2011) Zoster sine herpete: it would be rash to ignore it. Neurology 76:416\u2013417","journal-title":"Neurology"},{"key":"10265_CR18","doi-asserted-by":"publisher","first-page":"439","DOI":"10.1007\/s11940-013-0246-5","volume":"15","author":"MA Nagel","year":"2013","unstructured":"Nagel MA, Gilden D (2013) Complications of varicella zoster virus reactivation. Curr Treat Options Neurol 15:439\u2013445","journal-title":"Curr Treat Options Neurol"},{"key":"10265_CR19","first-page":"45","volume-title":"Neurologic complications in organ transplant recipients","author":"SJ Forman","year":"1999","unstructured":"Forman SJ, Openshaw H (1999) Bone marrow (Hematopoietic cell) transplantation. In: Wijdicks EFM (ed) Neurologic complications in organ transplant recipients. Butterworth and Co (Publishers) Ltd, Great Britain, pp 45\u201354"},{"issue":"3","key":"10265_CR20","doi-asserted-by":"publisher","first-page":"509","DOI":"10.1007\/s13311-016-0430-x","volume":"13","author":"PGE Kennedy","year":"2016","unstructured":"Kennedy PGE (2016) Issues in the treatment of neurological conditions caused by reactivation of varicella zoster virus (VZV). Neurotherapeutics 13(3):509\u2013513","journal-title":"Neurotherapeutics"},{"key":"10265_CR21","doi-asserted-by":"publisher","first-page":"1069","DOI":"10.1212\/01.wnl.0000258549.13334.16","volume":"68","author":"MA Nagel","year":"2007","unstructured":"Nagel MA, Forghani B, Mahalingam R, WellishMC CRJ, Russman AN, Katzan I, Lin R, Gardner CJ, Gilden DH (2007) The value of detecting anti-VZV IgG antibody in CSF to diagnose VZV vasculopathy. Neurology 68:1069\u20131073","journal-title":"Neurology"},{"issue":"9","key":"10265_CR22","doi-asserted-by":"publisher","first-page":"3543","DOI":"10.1172\/JCI92280","volume":"127","author":"B Ogunjimi","year":"2017","unstructured":"Ogunjimi B, Zhang SY, S\u00f8rensen KB, Skipper KA, Carter-Timofte M, Kerr G et al (2017) Inborn errors in RNA polymerase III underlie severe varicella zoster virus infections. J Clin Invest 127(9):3543\u20133556. https:\/\/doi.org\/10.1172\/JCI92280 (Epub 2017 Aug 7)","journal-title":"J Clin Invest"},{"issue":"10","key":"10265_CR23","doi-asserted-by":"publisher","first-page":"904","DOI":"10.1016\/j.molmed.2018.07.009","volume":"24","author":"ME Carter-Timofte","year":"2018","unstructured":"Carter-Timofte ME, Paludan SR, Mogensen TH (2018) RNA polymerase III as a gatekeeper to prevent severe VZV infections. Trends Mol Med 24(10):904\u2013915. https:\/\/doi.org\/10.1016\/j.molmed.2018.07.009 (Epub 2018 Aug 13)","journal-title":"Trends Mol Med"},{"issue":"8868","key":"10265_CR24","doi-asserted-by":"publisher","first-page":"398","DOI":"10.1016\/0140-6736(93)92814-a","volume":"1342","author":"P Cinque","year":"1993","unstructured":"Cinque P, Brytting M, Vago L, Castagna A, Parravicini C, Zanchetta N, D\u2019Arminio Monforte A, Wahren B, Lazzarin A, Linde A (1993) Epstein-Barr virus DNA in cerebrospinal fluid from patients with AIDS-related primary lymphoma of the central nervous system. Lancet 1342(8868):398\u2013401. https:\/\/doi.org\/10.1016\/0140-6736(93)92814-a","journal-title":"Lancet"},{"issue":"10","key":"10265_CR25","doi-asserted-by":"publisher","first-page":"2053","DOI":"10.1007\/s00467-013-2499-3","volume":"28","author":"V Said-Conti","year":"2013","unstructured":"Said-Conti V, Amrolia PJ, Gaze MN, Stoneham S, Sebire N, Shroff R, Marks SD et al (2013) Successful treatment of central nervous system PTLD with rituximab and cranial radiotherapy. Pediatr Nephrol 28(10):2053\u20132056. https:\/\/doi.org\/10.1007\/s00467-013-2499-3 (Epub 2013 Jun 7)","journal-title":"Pediatr Nephrol"},{"issue":"4","key":"10265_CR26","doi-asserted-by":"publisher","first-page":"729","DOI":"10.3201\/eid1004.030587","volume":"10","author":"E Denes","year":"2004","unstructured":"Denes E, Magy L, Pradeau K, Alain S, Weinbreck P, Ranger-Rogez S (2004) Successful treatment of human herpesvirus 6 encephalomyelitis in immunocompetent patient). Emerg Infect Dis 10(4):729\u2013731. https:\/\/doi.org\/10.3201\/eid1004.030587","journal-title":"Emerg Infect Dis"},{"key":"10265_CR27","doi-asserted-by":"publisher","first-page":"375","DOI":"10.1056\/NEJMoa051847","volume":"353","author":"A Langer-Gould","year":"2005","unstructured":"Langer-Gould A, Atlas SW, Green AJ, Bollen AW (2005) Pelletier D Progressive multifocal leukoencephalopathy in a patient treated with natalizumab. N Engl J Med 353:375\u2013381","journal-title":"N Engl J Med"},{"issue":"9","key":"10265_CR28","doi-asserted-by":"publisher","first-page":"924","DOI":"10.1056\/NEJMoa054693","volume":"354","author":"TA Yousry","year":"2006","unstructured":"Yousry TA, Major EO, Ryschkewitsch C, Fahle G, Fischer S, Hou J et al (2006) Evaluation of patients treated with natalizumab for progressive multifocal leukoencephalopathy. N Engl J Med 354(9):924\u2013933. https:\/\/doi.org\/10.1056\/NEJMoa054693","journal-title":"N Engl J Med"},{"key":"10265_CR29","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1146\/annurev-pathol-020712-164018","volume":"8","author":"S Gheuens","year":"2013","unstructured":"Gheuens S, W\u00fcthrich C, Koralnik IJ (2013) Progressive multifocal leukoencephalopathy: why gray and white matter. Annu Rev Pathol 8:189\u2013215","journal-title":"Annu Rev Pathol"},{"key":"10265_CR30","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1016\/j.pediatrneurol.2016.06.014","volume":"64","author":"J Gofshteyn","year":"2016","unstructured":"Gofshteyn J, C\u00e1rdenas AM, Bearden D (2016) Treatment of chronic enterovirus encephalitis with fluoxetine in a patient with X-linked agammaglobulinemia. Pediatr Neurol 64:94\u201398. https:\/\/doi.org\/10.1016\/j.pediatrneurol.2016.06.014 (Epub 2016 Jun 25)","journal-title":"Pediatr Neurol"},{"key":"10265_CR31","doi-asserted-by":"publisher","unstructured":"Fisher DL, Defres S, Solomon T (2015) QJM. Measles-induced encephalitis 108(3):177\u201382. https:\/\/doi.org\/10.1093\/qjmed\/hcu113. Epub 2014 May 26","DOI":"10.1093\/qjmed\/hcu113"},{"issue":"2","key":"10265_CR32","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1542\/peds.59.2.232","volume":"59","author":"J Aicardi","year":"1977","unstructured":"Aicardi J, Goutieres F, Arsenio-Nunes ML, Lebon P (1977) Acute measles encephalitis in children with immunosuppression. Pediatrics 59(2):232\u2013239","journal-title":"Pediatrics"},{"issue":"11","key":"10265_CR33","doi-asserted-by":"publisher","first-page":"1061","DOI":"10.1001\/jama.2020.1585","volume":"323","author":"D Wang","year":"2020","unstructured":"Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, Wang B, Xiang H, Cheng Z, Xiong Y, Zhao Y, Li Y, Wang X, Peng Z (2020) Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan China. JAMA 323(11):1061\u20131069. https:\/\/doi.org\/10.1001\/jama.2020.1585 ((Online ahead of print))","journal-title":"JAMA"},{"issue":"2","key":"10265_CR34","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1007\/s13365-020-00840-5","volume":"26","author":"JR Berger","year":"2020","unstructured":"Berger JR (2020) COVID-19 and the nervous system. J Neurovirol 26(2):143\u2013148. https:\/\/doi.org\/10.1007\/s13365-020-00840-5 (Epub 2020 May 23)","journal-title":"J Neurovirol"},{"key":"10265_CR35","doi-asserted-by":"publisher","first-page":"518","DOI":"10.3389\/fneur.2020.00518","volume":"11","author":"MU Ahmed","year":"2020","unstructured":"Ahmed MU, Hanif M, Ali MJ, Haider MA, Kherani D, Memon GM, Karim AH, Sattar A (2020) Neurological manifestations of COVID-19 (SARS-CoV-2). Rev Front Neurol 11:518. https:\/\/doi.org\/10.3389\/fneur.2020.00518 ((eCollection 2020))","journal-title":"Rev Front Neurol"},{"key":"10265_CR36","doi-asserted-by":"publisher","first-page":"1606","DOI":"10.3389\/fimmu.2020.01606","volume":"11","author":"ME Carter-Timofte","year":"2020","unstructured":"Carter-Timofte ME, J\u00f8rgensen SE, Freytag MR, Thomsen MM, Brinck Andersen NS, Al-Mousawi A, Hait AS, Mogensen TH (2020) Deciphering the role of host genetics in susceptibility to severe COVID-19. Front Immunol 11:1606. https:\/\/doi.org\/10.3389\/fimmu.2020.01606 ((eCollection 2020))","journal-title":"Front Immunol"},{"key":"10265_CR37","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiaa446","author":"M Helleberg","year":"2020","unstructured":"Helleberg M, Niemann CU, Moestrup K, Kirk O, Lebech AM, Lane C, Lundgren J (2020) Persistent COVID-19 in an immunocompromised patient temporarily responsive to two courses of remdesivir therapy. J Infect Dis. https:\/\/doi.org\/10.1093\/infdis\/jiaa446 ((jiaa446, Online ahead of print))","journal-title":"J Infect Dis"}],"container-title":["Journal of Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00415-020-10265-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00415-020-10265-z\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00415-020-10265-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,11,23]],"date-time":"2022-11-23T03:48:33Z","timestamp":1669175313000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00415-020-10265-z"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,13]]},"references-count":37,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2021,8]]}},"alternative-id":["10265"],"URL":"https:\/\/doi.org\/10.1007\/s00415-020-10265-z","relation":{},"ISSN":["0340-5354","1432-1459"],"issn-type":[{"value":"0340-5354","type":"print"},{"value":"1432-1459","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10,13]]},"assertion":[{"value":"18 September 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 October 2020","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 October 2020","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 October 2020","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"I declare that I have no conflicts of interest to report.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}}]}}