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Cytomegalovirus encephalitis associated with episodic neurologic deficits and OKT-8⁺ pleocytosis

Department of Neurology (Drs. Richert, Potolicchio, Manz, and Cohan), the Division of Infertious Diseases of the Department of Medicine (Dr. Garagusi), and the Department of Pathology (Drs. Manz and Hartmann), Georgetown University Medical Center, Washington, DC; and the Department of Neurology (Dr. Johnson), The Johns Hopkins University School of Medi cine, Baltimore, MD.

After 3 days of symptoms suggesting a viral illness, a 35-year-old man experienced three episodes of aphasia, right-sided sensory symptoms, and bifrontal headache. Each lasted several hours. CSF examination revealed a moderate lymphocytosis consisting of 80% OKT-8⁺ cells. Serum anti-cytomegalovirus (anti-CMV) antibody titer was elevated at 1:1,024 and subsequently fell to 1:64. Episodic symptoms recurred 5 months later, at which time the anti-CMV titer peaked at 1:8,192. A trial of inhaled oxygen aborted two episodes after several minutes each.

Address correspondence and reprint requests to Dr. Richert, Department of Neurology, Georgetown University Medical Center, 3800 Reservoir Road, NW, Washington, DC 20007.

Dr. Richert is the recipient of an NINCDS Teacher Investigator Award.

Received January 24, 1986. Accepted for publication April 10, 1986

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