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Table 1 Common viruses associated with seizures and epilepsy

From: Seizures and epilepsy secondary to viral infection in the central nervous system

Genus or family [6] Virus and type of nucleic acid [6] Route of transmission Geographical distribution Peak seasonal incidence Laboratory testing
Flaviviridae Japanese encephalitis virus (RNA virus) Transmitted by genus Culex India, China, Japan, South East Asia, Eastern Mediterranean region, Papua New Guinea, Australia [1] Summer and early fall CSF PCR; serum and CSF IgM (elevated in CSF in the first few days, sensitivity and specificity > 90%) and IgG [7]
  Dengue virus (RNA virus) Transmitted by genus Aedes India, China, Japan, South East Asia, Eastern Mediterranean region, Papua New Guinea, Australia [8] Summer and early fall PCR or antigen testing of respiratory secretions [8]
  Zika virus (RNA virus) Transmitted by genus Aedes; mother-to-child transmission through placenta; sexual transmission [9] Africa, South America, Southeast Asia (Pacific region) More frequent in summer and early fall (in the temperate zone); no seasonality (in the tropics) Serum or urine PCR; serum or CSF IgM [9]
Herpesviridae Herpes simplex virus (DNA virus) Sexual; contact transmission Worldwide No seasonality CSF PCR [8]; CSF IgG (if neurological manifestations last more than a week) [10, 11]
  Cytomegalovirus (DNA virus) Mother-to-child transmission through placenta, labour, breast milk; sexual transmission; blood transfusion Worldwide No seasonality Serum and CSF PCR; serum and CSF IgM or IgG [8]
  Varicella zoster virus (DNA virus) Close contact and droplet transmission [12] Worldwide All seasons, more frequently in late winter and spring [12] CSF PCR
  Epstein Barr virus (DNA virus) Saliva or droplets transmission [13] Worldwide No seasonality CSF PCR; serum viral capsid antigen, IgM [14]
Retroviridae Human immunodeficiency virus (RNA virus) Sexual transmission; direct contact; blood or blood products Sub-Saharan Africa, Central Asia, Latin, America, Eastern Europe [1] No seasonality PCR or serum IgG
Paramyxoviridae Measles virus (RNA virus) Droplet transmission; direct contact with nasal or throat secretions [15] Worldwide [8] All seasons, more frequently in late spring Serum IgM; CSF PCR; nasopharyngeal, throat or urine PCR [8]
  Mumps virus (RNA virus) Droplet transmission Worldwide [8] Winter and spring (in the temperate zone); no seasonality (in the tropics) [16] Serum IgM; CSF PCR (high sensitivity); viral isolation from CSF, saliva, urine [8]
  Nipah virus (RNA virus) Droplet transmission; direct contact transmission (bats-to-human, pigs-to-human, human-to-human occasionally) [17] Bangladesh, India, South-East Asia, Australia [8] More frequent from January to May [18] Serum and CSF IgM/IgG; CSF, serum and urine PCR [8]
Orthomyxoviridae Influenza (RNA virus) Droplet transmission; contact transmission Worldwide distribution but encephalopathy most frequently reported in Japan and Australia [8] Winter and spring Nasopharyngeal swab, respiratory secretions PCR [19]
  1. CSF: cerebrospinal fluid; PCR: polymerase chain reaction; IgM: immunoglobulin M; IgG: immunoglobulin G