General principles

Invasion of the nervous system may occur as part of a generalised viral infection.

Occasionally nervous system involvement is disproportionately severe and symptoms of generalised infection are slight.

Viruses enter the body through the: respiratory tract, gastrointestinal tract, genitourinary tract or by inoculation through the skin.

previous —^ patient's IgA neutralises Viral entry exposure ^ vims

^ no previous exposure -viraemia

Routes of spread to CNS

Massive viraemia overcomes monocyte and reticuloendothelial defence systems

Infection along peripheral nerves

Invades CNS via capillaries and veins

Invades CNS

After CNS penetration, the clinical picture depends upon the particular virus and the cells of the nervous system which show a specific susceptibility.

meninges-meningitis ~

encephalitis-----

^ myelitis motor neurons of cranial and spinal nerves - poliomyelitis------ - ->-

dorsal root ganglia radiculitis

Some viruses cause a chronic, progressive infection, others remain dormant for many years within the nervous system before becoming symptomatic.

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