ArticleBMC infectious diseases2012
Evidence for an enterovirus as the cause of encephalitis lethargica.
Article in BMC infectious diseases, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Bacterial, viral, and fungal infection-related risk of Parkinson's disease: Meta-analysis of cohort and case-control studies.Brain and behavior · 2020Pooled it
- Human pegivirus alters brain and blood immune and transcriptomic profiles of patients with Parkinson's disease.JCI insight · 2025Article
- Parkinsonism due to Coxsackie B Virus Infection-Case Report and Literature Review.Movement disorders clinical practice · 2023Article
- Infectious Microorganisms Seen as Etiologic Agents in Parkinson's Disease.Life (Basel, Switzerland) · 2023Review
- Microglial Priming in Infections and Its Risk to Neurodegenerative Diseases.Frontiers in cellular neuroscience · 2022Review
- Rhinovirus C replication is associated with the endoplasmic reticulum and triggers cytopathic effects in an in vitro model of human airway epithelium.PLoS pathogens · 2022Article
- Linking COVID-19 and Parkinson's disease: Targeting the role of Vitamin-D.Biochemical and biophysical research communications · 2021Article
- De Novo Movement Disorders and COVID-19: Exploring the Interface.Movement disorders clinical practice · 2021Review
- Impact of the COVID-19 Pandemic on Parkinson's Disease and Movement Disorders.Movement disorders : official journal of the Movement Disorder Society · 2020Article
- Impact of the COVID-19 Pandemic on Parkinson's Disease and Movement Disorders.Movement disorders clinical practice · 2020Article
- The Challenge of Managing Parkinson's Disease Patients during the COVID-19 Pandemic.Annals of Indian Academy of Neurology · 2020Article
- COVID-19 and possible links with Parkinson's disease and parkinsonism: from bench to bedside.NPJ Parkinson's disease · 2020Review
- Meningitis gone viral: description of the echovirus wave 2013 in Germany.BMC infectious diseases · 2019Article
- Parkinsonism Caused by Viral Encephalitis Affecting the Bilateral Substantia Nigra.Clinical neuroradiology · 2019Article
- Virus-like particles and enterovirus antigen found in the brainstem neurons of Parkinson's disease.F1000Research · 2018Article
- Peripheral aetiopathogenic drivers and mediators of Parkinson's disease and co-morbidities: role of gastrointestinal microbiota.Journal of neurovirology · 2016Review
- Elucidation of echovirus 30's origin and transmission during the 2012 aseptic meningitis outbreak in Guangdong, China, through continuing environmental surveillance.Applied and environmental microbiology · 2015Article
- History of narcolepsy at Stanford University.Immunologic research · 2014Review
- The Demise of Poskanzer and Schwab's Influenza Theory on the Pathogenesis of Parkinson's Disease.Parkinson's disease · 2013Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe epidemic of encephalitis lethargica (EL), called classical EL, was rampant throughout the world during 1917-1926, affecting half a million persons. The acute phase was lethal for many victims. Post-encephalitic parkinsonism (PEP) affected patients for decades. Our purpose was to investigate the cause of classical EL by studying the few available brain specimens. Cases of PEP and modern EL were also studied. Transmission electron microscopy (TEM) and immunohistochemistry were employed to examine brain from four classical EL cases, two modern EL cases and one PEP case.
methodsStandard methods for TEM, immunohistochemistry and RTPCR were applied.
results27 nm virus-like particles (VLP) were observed in the cytoplasm and nuclei of midbrain neurons in all classical EL cases studied. Large (50 nm) VLP and 27 nm intranuclear VLP were observed in the modern EL cases and the PEP case. Influenza virus particles were not found. VLP were not observed in the control cases. TEM of cell cultures inoculated with coxsackievirus B4 and poliovirus revealed both small and large intranuclear virus particles and small cytoplasmic particles, similar to the VLP in EL neurons. In the EL brains, nascent VLP were embedded in putative virus factories and on endoplasmic reticulum (ER). The VLP in the cases of classical EL survived, whereas ribosomes underwent autolysis due to the lack of refrigeration and slow formaldehyde fixation of whole brain. The VLP were larger than ribosomes from well preserved brain. Immunohistochemistry of classical EL cases using anti-poliovirus and anti-coxsackievirus B polyclonal antibodies showed significant staining of cytoplasm and nuclei of neurons as well as microglia and neuropil. Purkinje cells were strongly stained.A 97-bp RNA fragment of a unique virus was isolated from brain tissue from acute EL case #91558. Sequence analysis revealed up to 95% identity to multiple human Enteroviruses. Additional cases had Enterovirus positive reactions by real time PCR.
conclusionsThe data presented here support the hypothesis that the VLP observed in EL tissue is an Enterovirus.
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