Clinical phenotype and outcome of hepatitis E virus-associated neuralgic amyotrophy.

Autor:	van Eijk JJJ; From the Jeroen Bosch Hospital (J.J.J.v.E.), 's-Hertogenbosch, the Netherlands; Royal Cornwall Hospital (H.R.D., R.G.M., C.J., J. Herrod, R.F.L., H.H.A., M.A., O.A.B.A.L.M., B.N.M., R.P.B.); European Centre for the Environment and Human Health (H.R.D., R.P.B.), University of Exeter, Truro, UK; Neurocenter of Southern Switzerland (P.R., C.G., G.M.), Lugano; Department of Neurology and Neuroscience (M.F.) and Institute for Virology (M.P.), Medical Center-University of Freiburg and Faculty of Medicine, University of Freiburg, Germany; Microbiology Department (E.P.), EOLAB (SMIC), Bellinzona, Switzerland; University Hospital Lausanne (CHUV) (M.F., D.B., T.K., V.A., R.S., D.M.), Switzerland; Université Paul Sabatier (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Centre Hospitalo-Universitaire Timone (S.A., R.G., P.C.); IHU-Méditerranée Infection (P.C.), Aix-Marseille Université, AP-HM, France; San Bortolo Hospital (M.T.G.), Vicenza, Italy; University Medical Center Hamburg-Eppendorf (J. Hartl, S.P.), Germany; Northumbria University (N.X.L.), Newcastle upon Tyne, UK; CHU Rangueil (N.K.); CHU Purpan (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Erasmus MC (B.C.J.), University Medical Centre Rotterdam; and Department of Neurology (N.v.A., B.G.M.v.E.), Donders Center for Medical Neuroscience, Radboudumc Nijmegen, the Netherlands., Dalton HR; From the Jeroen Bosch Hospital (J.J.J.v.E.), 's-Hertogenbosch, the Netherlands; Royal Cornwall Hospital (H.R.D., R.G.M., C.J., J. Herrod, R.F.L., H.H.A., M.A., O.A.B.A.L.M., B.N.M., R.P.B.); European Centre for the Environment and Human Health (H.R.D., R.P.B.), University of Exeter, Truro, UK; Neurocenter of Southern Switzerland (P.R., C.G., G.M.), Lugano; Department of Neurology and Neuroscience (M.F.) and Institute for Virology (M.P.), Medical Center-University of Freiburg and Faculty of Medicine, University of Freiburg, Germany; Microbiology Department (E.P.), EOLAB (SMIC), Bellinzona, Switzerland; University Hospital Lausanne (CHUV) (M.F., D.B., T.K., V.A., R.S., D.M.), Switzerland; Université Paul Sabatier (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Centre Hospitalo-Universitaire Timone (S.A., R.G., P.C.); IHU-Méditerranée Infection (P.C.), Aix-Marseille Université, AP-HM, France; San Bortolo Hospital (M.T.G.), Vicenza, Italy; University Medical Center Hamburg-Eppendorf (J. Hartl, S.P.), Germany; Northumbria University (N.X.L.), Newcastle upon Tyne, UK; CHU Rangueil (N.K.); CHU Purpan (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Erasmus MC (B.C.J.), University Medical Centre Rotterdam; and Department of Neurology (N.v.A., B.G.M.v.E.), Donders Center for Medical Neuroscience, Radboudumc Nijmegen, the Netherlands. hardalton@gmail.com., Ripellino P; From the Jeroen Bosch Hospital (J.J.J.v.E.), 's-Hertogenbosch, the Netherlands; Royal Cornwall Hospital (H.R.D., R.G.M., C.J., J. Herrod, R.F.L., H.H.A., M.A., O.A.B.A.L.M., B.N.M., R.P.B.); European Centre for the Environment and Human Health (H.R.D., R.P.B.), University of Exeter, Truro, UK; Neurocenter of Southern Switzerland (P.R., C.G., G.M.), Lugano; Department of Neurology and Neuroscience (M.F.) and Institute for Virology (M.P.), Medical Center-University of Freiburg and Faculty of Medicine, University of Freiburg, Germany; Microbiology Department (E.P.), EOLAB (SMIC), Bellinzona, Switzerland; University Hospital Lausanne (CHUV) (M.F., D.B., T.K., V.A., R.S., D.M.), Switzerland; Université Paul Sabatier (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Centre Hospitalo-Universitaire Timone (S.A., R.G., P.C.); IHU-Méditerranée Infection (P.C.), Aix-Marseille Université, AP-HM, France; San Bortolo Hospital (M.T.G.), Vicenza, Italy; University Medical Center Hamburg-Eppendorf (J. Hartl, S.P.), Germany; Northumbria University (N.X.L.), Newcastle upon Tyne, UK; CHU Rangueil (N.K.); CHU Purpan (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Erasmus MC (B.C.J.), University Medical Centre Rotterdam; and Department of Neurology (N.v.A., B.G.M.v.E.), Donders Center for Medical Neuroscience, Radboudumc Nijmegen, the Netherlands., Madden RG; From the Jeroen Bosch Hospital (J.J.J.v.E.), 's-Hertogenbosch, the Netherlands; Royal Cornwall Hospital (H.R.D., R.G.M., C.J., J. Herrod, R.F.L., H.H.A., M.A., O.A.B.A.L.M., B.N.M., R.P.B.); European Centre for the Environment and Human Health (H.R.D., R.P.B.), University of Exeter, Truro, UK; Neurocenter of Southern Switzerland (P.R., C.G., G.M.), Lugano; Department of Neurology and Neuroscience (M.F.) and Institute for Virology (M.P.), Medical Center-University of Freiburg and Faculty of Medicine, University of Freiburg, Germany; Microbiology Department (E.P.), EOLAB (SMIC), Bellinzona, Switzerland; University Hospital Lausanne (CHUV) (M.F., D.B., T.K., V.A., R.S., D.M.), Switzerland; Université Paul Sabatier (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Centre Hospitalo-Universitaire Timone (S.A., R.G., P.C.); IHU-Méditerranée Infection (P.C.), Aix-Marseille Université, AP-HM, France; San Bortolo Hospital (M.T.G.), Vicenza, Italy; University Medical Center Hamburg-Eppendorf (J. Hartl, S.P.), Germany; Northumbria University (N.X.L.), Newcastle upon Tyne, UK; CHU Rangueil (N.K.); CHU Purpan (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Erasmus MC (B.C.J.), University Medical Centre Rotterdam; and Department of Neurology (N.v.A., B.G.M.v.E.), Donders Center for Medical Neuroscience, Radboudumc Nijmegen, the Netherlands., Jones C; From the Jeroen Bosch Hospital (J.J.J.v.E.), 's-Hertogenbosch, the Netherlands; Royal Cornwall Hospital (H.R.D., R.G.M., C.J., J. Herrod, R.F.L., H.H.A., M.A., O.A.B.A.L.M., B.N.M., R.P.B.); European Centre for the Environment and Human Health (H.R.D., R.P.B.), University of Exeter, Truro, UK; Neurocenter of Southern Switzerland (P.R., C.G., G.M.), Lugano; Department of Neurology and Neuroscience (M.F.) and Institute for Virology (M.P.), Medical Center-University of Freiburg and Faculty of Medicine, University of Freiburg, Germany; Microbiology Department (E.P.), EOLAB (SMIC), Bellinzona, Switzerland; University Hospital Lausanne (CHUV) (M.F., D.B., T.K., V.A., R.S., D.M.), Switzerland; Université Paul Sabatier (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Centre Hospitalo-Universitaire Timone (S.A., R.G., P.C.); IHU-Méditerranée Infection (P.C.), Aix-Marseille Université, AP-HM, France; San Bortolo Hospital (M.T.G.), Vicenza, Italy; University Medical Center Hamburg-Eppendorf (J. Hartl, S.P.), Germany; Northumbria University (N.X.L.), Newcastle upon Tyne, UK; CHU Rangueil (N.K.); CHU Purpan (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Erasmus MC (B.C.J.), University Medical Centre Rotterdam; and Department of Neurology (N.v.A., B.G.M.v.E.), Donders Center for Medical Neuroscience, Radboudumc Nijmegen, the Netherlands., Fritz M; From the Jeroen Bosch Hospital (J.J.J.v.E.), 's-Hertogenbosch, the Netherlands; Royal Cornwall Hospital (H.R.D., R.G.M., C.J., J. Herrod, R.F.L., H.H.A., M.A., O.A.B.A.L.M., B.N.M., R.P.B.); European Centre for the Environment and Human Health (H.R.D., R.P.B.), University of Exeter, Truro, UK; Neurocenter of Southern Switzerland (P.R., C.G., G.M.), Lugano; Department of Neurology and Neuroscience (M.F.) and Institute for Virology (M.P.), Medical Center-University of Freiburg and Faculty of Medicine, University of Freiburg, Germany; Microbiology Department (E.P.), EOLAB (SMIC), Bellinzona, Switzerland; University Hospital Lausanne (CHUV) (M.F., D.B., T.K., V.A., R.S., D.M.), Switzerland; Université Paul Sabatier (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Centre Hospitalo-Universitaire Timone (S.A., R.G., P.C.); IHU-Méditerranée Infection (P.C.), Aix-Marseille Université, AP-HM, France; San Bortolo Hospital (M.T.G.), Vicenza, Italy; University Medical Center Hamburg-Eppendorf (J. Hartl, S.P.), Germany; Northumbria University (N.X.L.), Newcastle upon Tyne, UK; CHU Rangueil (N.K.); CHU Purpan (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Erasmus MC (B.C.J.), University Medical Centre Rotterdam; and Department of Neurology (N.v.A., B.G.M.v.E.), Donders Center for Medical Neuroscience, Radboudumc Nijmegen, the Netherlands., Gobbi C; From the Jeroen Bosch Hospital (J.J.J.v.E.), 's-Hertogenbosch, the Netherlands; Royal Cornwall Hospital (H.R.D., R.G.M., C.J., J. Herrod, R.F.L., H.H.A., M.A., O.A.B.A.L.M., B.N.M., R.P.B.); European Centre for the Environment and Human Health (H.R.D., R.P.B.), University of Exeter, Truro, UK; Neurocenter of Southern Switzerland (P.R., C.G., G.M.), Lugano; Department of Neurology and Neuroscience (M.F.) and Institute for Virology (M.P.), Medical Center-University of Freiburg and Faculty of Medicine, University of Freiburg, Germany; Microbiology Department (E.P.), EOLAB (SMIC), Bellinzona, Switzerland; University Hospital Lausanne (CHUV) (M.F., D.B., T.K., V.A., R.S., D.M.), Switzerland; Université Paul Sabatier (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Centre Hospitalo-Universitaire Timone (S.A., R.G., P.C.); IHU-Méditerranée Infection (P.C.), Aix-Marseille Université, AP-HM, France; San Bortolo Hospital (M.T.G.), Vicenza, Italy; University Medical Center Hamburg-Eppendorf (J. Hartl, S.P.), Germany; Northumbria University (N.X.L.), Newcastle upon Tyne, UK; CHU Rangueil (N.K.); CHU Purpan (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Erasmus MC (B.C.J.), University Medical Centre Rotterdam; and Department of Neurology (N.v.A., B.G.M.v.E.), Donders Center for Medical Neuroscience, Radboudumc Nijmegen, the Netherlands., Melli G; From the Jeroen Bosch Hospital (J.J.J.v.E.), 's-Hertogenbosch, the Netherlands; Royal Cornwall Hospital (H.R.D., R.G.M., C.J., J. Herrod, R.F.L., H.H.A., M.A., O.A.B.A.L.M., B.N.M., R.P.B.); European Centre for the Environment and Human Health (H.R.D., R.P.B.), University of Exeter, Truro, UK; Neurocenter of Southern Switzerland (P.R., C.G., G.M.), Lugano; Department of Neurology and Neuroscience (M.F.) and Institute for Virology (M.P.), Medical Center-University of Freiburg and Faculty of Medicine, University of Freiburg, Germany; Microbiology Department (E.P.), EOLAB (SMIC), Bellinzona, Switzerland; University Hospital Lausanne (CHUV) (M.F., D.B., T.K., V.A., R.S., D.M.), Switzerland; Université Paul Sabatier (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Centre Hospitalo-Universitaire Timone (S.A., R.G., P.C.); IHU-Méditerranée Infection (P.C.), Aix-Marseille Université, AP-HM, France; San Bortolo Hospital (M.T.G.), Vicenza, Italy; University Medical Center Hamburg-Eppendorf (J. Hartl, S.P.), Germany; Northumbria University (N.X.L.), Newcastle upon Tyne, UK; CHU Rangueil (N.K.); CHU Purpan (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Erasmus MC (B.C.J.), University Medical Centre Rotterdam; and Department of Neurology (N.v.A., B.G.M.v.E.), Donders Center for Medical Neuroscience, Radboudumc Nijmegen, the Netherlands., Pasi E; From the Jeroen Bosch Hospital (J.J.J.v.E.), 's-Hertogenbosch, the Netherlands; Royal Cornwall Hospital (H.R.D., R.G.M., C.J., J. Herrod, R.F.L., H.H.A., M.A., O.A.B.A.L.M., B.N.M., R.P.B.); European Centre for the Environment and Human Health (H.R.D., R.P.B.), University of Exeter, Truro, UK; Neurocenter of Southern Switzerland (P.R., C.G., G.M.), Lugano; Department of Neurology and Neuroscience (M.F.) and Institute for Virology (M.P.), Medical Center-University of Freiburg and Faculty of Medicine, University of Freiburg, Germany; Microbiology Department (E.P.), EOLAB (SMIC), Bellinzona, Switzerland; University Hospital Lausanne (CHUV) (M.F., D.B., T.K., V.A., R.S., D.M.), Switzerland; Université Paul Sabatier (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Centre Hospitalo-Universitaire Timone (S.A., R.G., P.C.); IHU-Méditerranée Infection (P.C.), Aix-Marseille Université, AP-HM, France; San Bortolo Hospital (M.T.G.), Vicenza, Italy; University Medical Center Hamburg-Eppendorf (J. Hartl, S.P.), Germany; Northumbria University (N.X.L.), Newcastle upon Tyne, UK; CHU Rangueil (N.K.); CHU Purpan (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Erasmus MC (B.C.J.), University Medical Centre Rotterdam; and Department of Neurology (N.v.A., B.G.M.v.E.), Donders Center for Medical Neuroscience, Radboudumc Nijmegen, the Netherlands., Herrod J; From the Jeroen Bosch Hospital (J.J.J.v.E.), 's-Hertogenbosch, the Netherlands; Royal Cornwall Hospital (H.R.D., R.G.M., C.J., J. Herrod, R.F.L., H.H.A., M.A., O.A.B.A.L.M., B.N.M., R.P.B.); European Centre for the Environment and Human Health (H.R.D., R.P.B.), University of Exeter, Truro, UK; Neurocenter of Southern Switzerland (P.R., C.G., G.M.), Lugano; Department of Neurology and Neuroscience (M.F.) and Institute for Virology (M.P.), Medical Center-University of Freiburg and Faculty of Medicine, University of Freiburg, Germany; Microbiology Department (E.P.), EOLAB (SMIC), Bellinzona, Switzerland; University Hospital Lausanne (CHUV) (M.F., D.B., T.K., V.A., R.S., D.M.), Switzerland; Université Paul Sabatier (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Centre Hospitalo-Universitaire Timone (S.A., R.G., P.C.); IHU-Méditerranée Infection (P.C.), Aix-Marseille Université, AP-HM, France; San Bortolo Hospital (M.T.G.), Vicenza, Italy; University Medical Center Hamburg-Eppendorf (J. Hartl, S.P.), Germany; Northumbria University (N.X.L.), Newcastle upon Tyne, UK; CHU Rangueil (N.K.); CHU Purpan (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Erasmus MC (B.C.J.), University Medical Centre Rotterdam; and Department of Neurology (N.v.A., B.G.M.v.E.), Donders Center for Medical Neuroscience, Radboudumc Nijmegen, the Netherlands., Lissmann RF; From the Jeroen Bosch Hospital (J.J.J.v.E.), 's-Hertogenbosch, the Netherlands; Royal Cornwall Hospital (H.R.D., R.G.M., C.J., J. Herrod, R.F.L., H.H.A., M.A., O.A.B.A.L.M., B.N.M., R.P.B.); European Centre for the Environment and Human Health (H.R.D., R.P.B.), University of Exeter, Truro, UK; Neurocenter of Southern Switzerland (P.R., C.G., G.M.), Lugano; Department of Neurology and Neuroscience (M.F.) and Institute for Virology (M.P.), Medical Center-University of Freiburg and Faculty of Medicine, University of Freiburg, Germany; Microbiology Department (E.P.), EOLAB (SMIC), Bellinzona, Switzerland; University Hospital Lausanne (CHUV) (M.F., D.B., T.K., V.A., R.S., D.M.), Switzerland; Université Paul Sabatier (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Centre Hospitalo-Universitaire Timone (S.A., R.G., P.C.); IHU-Méditerranée Infection (P.C.), Aix-Marseille Université, AP-HM, France; San Bortolo Hospital (M.T.G.), Vicenza, Italy; University Medical Center Hamburg-Eppendorf (J. Hartl, S.P.), Germany; Northumbria University (N.X.L.), Newcastle upon Tyne, UK; CHU Rangueil (N.K.); CHU Purpan (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Erasmus MC (B.C.J.), University Medical Centre Rotterdam; and Department of Neurology (N.v.A., B.G.M.v.E.), Donders Center for Medical Neuroscience, Radboudumc Nijmegen, the Netherlands., Ashraf HH; From the Jeroen Bosch Hospital (J.J.J.v.E.), 's-Hertogenbosch, the Netherlands; Royal Cornwall Hospital (H.R.D., R.G.M., C.J., J. Herrod, R.F.L., H.H.A., M.A., O.A.B.A.L.M., B.N.M., R.P.B.); European Centre for the Environment and Human Health (H.R.D., R.P.B.), University of Exeter, Truro, UK; Neurocenter of Southern Switzerland (P.R., C.G., G.M.), Lugano; Department of Neurology and Neuroscience (M.F.) and Institute for Virology (M.P.), Medical Center-University of Freiburg and Faculty of Medicine, University of Freiburg, Germany; Microbiology Department (E.P.), EOLAB (SMIC), Bellinzona, Switzerland; University Hospital Lausanne (CHUV) (M.F., D.B., T.K., V.A., R.S., D.M.), Switzerland; Université Paul Sabatier (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Centre Hospitalo-Universitaire Timone (S.A., R.G., P.C.); IHU-Méditerranée Infection (P.C.), Aix-Marseille Université, AP-HM, France; San Bortolo Hospital (M.T.G.), Vicenza, Italy; University Medical Center Hamburg-Eppendorf (J. Hartl, S.P.), Germany; Northumbria University (N.X.L.), Newcastle upon Tyne, UK; CHU Rangueil (N.K.); CHU Purpan (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Erasmus MC (B.C.J.), University Medical Centre Rotterdam; and Department of Neurology (N.v.A., B.G.M.v.E.), Donders Center for Medical Neuroscience, Radboudumc Nijmegen, the Netherlands., Abdelrahim M; From the Jeroen Bosch Hospital (J.J.J.v.E.), 's-Hertogenbosch, the Netherlands; Royal Cornwall Hospital (H.R.D., R.G.M., C.J., J. Herrod, R.F.L., H.H.A., M.A., O.A.B.A.L.M., B.N.M., R.P.B.); European Centre for the Environment and Human Health (H.R.D., R.P.B.), University of Exeter, Truro, UK; Neurocenter of Southern Switzerland (P.R., C.G., G.M.), Lugano; Department of Neurology and Neuroscience (M.F.) and Institute for Virology (M.P.), Medical Center-University of Freiburg and Faculty of Medicine, University of Freiburg, Germany; Microbiology Department (E.P.), EOLAB (SMIC), Bellinzona, Switzerland; University Hospital Lausanne (CHUV) (M.F., D.B., T.K., V.A., R.S., D.M.), Switzerland; Université Paul Sabatier (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Centre Hospitalo-Universitaire Timone (S.A., R.G., P.C.); IHU-Méditerranée Infection (P.C.), Aix-Marseille Université, AP-HM, France; San Bortolo Hospital (M.T.G.), Vicenza, Italy; University Medical Center Hamburg-Eppendorf (J. Hartl, S.P.), Germany; Northumbria University (N.X.L.), Newcastle upon Tyne, UK; CHU Rangueil (N.K.); CHU Purpan (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Erasmus MC (B.C.J.), University Medical Centre Rotterdam; and Department of Neurology (N.v.A., B.G.M.v.E.), Donders Center for Medical Neuroscience, Radboudumc Nijmegen, the Netherlands., Masri OABAL; From the Jeroen Bosch Hospital (J.J.J.v.E.), 's-Hertogenbosch, the Netherlands; Royal Cornwall Hospital (H.R.D., R.G.M., C.J., J. Herrod, R.F.L., H.H.A., M.A., O.A.B.A.L.M., B.N.M., R.P.B.); European Centre for the Environment and Human Health (H.R.D., R.P.B.), University of Exeter, Truro, UK; Neurocenter of Southern Switzerland (P.R., C.G., G.M.), Lugano; Department of Neurology and Neuroscience (M.F.) and Institute for Virology (M.P.), Medical Center-University of Freiburg and Faculty of Medicine, University of Freiburg, Germany; Microbiology Department (E.P.), EOLAB (SMIC), Bellinzona, Switzerland; University Hospital Lausanne (CHUV) (M.F., D.B., T.K., V.A., R.S., D.M.), Switzerland; Université Paul Sabatier (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Centre Hospitalo-Universitaire Timone (S.A., R.G., P.C.); IHU-Méditerranée Infection (P.C.), Aix-Marseille Université, AP-HM, France; San Bortolo Hospital (M.T.G.), Vicenza, Italy; University Medical Center Hamburg-Eppendorf (J. Hartl, S.P.), Germany; Northumbria University (N.X.L.), Newcastle upon Tyne, UK; CHU Rangueil (N.K.); CHU Purpan (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Erasmus MC (B.C.J.), University Medical Centre Rotterdam; and Department of Neurology (N.v.A., B.G.M.v.E.), Donders Center for Medical Neuroscience, Radboudumc Nijmegen, the Netherlands., Fraga M; From the Jeroen Bosch Hospital (J.J.J.v.E.), 's-Hertogenbosch, the Netherlands; Royal Cornwall Hospital (H.R.D., R.G.M., C.J., J. Herrod, R.F.L., H.H.A., M.A., O.A.B.A.L.M., B.N.M., R.P.B.); European Centre for the Environment and Human Health (H.R.D., R.P.B.), University of Exeter, Truro, UK; Neurocenter of Southern Switzerland (P.R., C.G., G.M.), Lugano; Department of Neurology and Neuroscience (M.F.) and Institute for Virology (M.P.), Medical Center-University of Freiburg and Faculty of Medicine, University of Freiburg, Germany; Microbiology Department (E.P.), EOLAB (SMIC), Bellinzona, Switzerland; University Hospital Lausanne (CHUV) (M.F., D.B., T.K., V.A., R.S., D.M.), Switzerland; Université Paul Sabatier (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Centre Hospitalo-Universitaire Timone (S.A., R.G., P.C.); IHU-Méditerranée Infection (P.C.), Aix-Marseille Université, AP-HM, France; San Bortolo Hospital (M.T.G.), Vicenza, Italy; University Medical Center Hamburg-Eppendorf (J. Hartl, S.P.), Germany; Northumbria University (N.X.L.), Newcastle upon Tyne, UK; CHU Rangueil (N.K.); CHU Purpan (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Erasmus MC (B.C.J.), University Medical Centre Rotterdam; and Department of Neurology (N.v.A., B.G.M.v.E.), Donders Center for Medical Neuroscience, Radboudumc Nijmegen, the Netherlands., Benninger D; From the Jeroen Bosch Hospital (J.J.J.v.E.), 's-Hertogenbosch, the Netherlands; Royal Cornwall Hospital (H.R.D., R.G.M., C.J., J. Herrod, R.F.L., H.H.A., M.A., O.A.B.A.L.M., B.N.M., R.P.B.); European Centre for the Environment and Human Health (H.R.D., R.P.B.), University of Exeter, Truro, UK; Neurocenter of Southern Switzerland (P.R., C.G., G.M.), Lugano; Department of Neurology and Neuroscience (M.F.) and Institute for Virology (M.P.), Medical Center-University of Freiburg and Faculty of Medicine, University of Freiburg, Germany; Microbiology Department (E.P.), EOLAB (SMIC), Bellinzona, Switzerland; University Hospital Lausanne (CHUV) (M.F., D.B., T.K., V.A., R.S., D.M.), Switzerland; Université Paul Sabatier (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Centre Hospitalo-Universitaire Timone (S.A., R.G., P.C.); IHU-Méditerranée Infection (P.C.), Aix-Marseille Université, AP-HM, France; San Bortolo Hospital (M.T.G.), Vicenza, Italy; University Medical Center Hamburg-Eppendorf (J. Hartl, S.P.), Germany; Northumbria University (N.X.L.), Newcastle upon Tyne, UK; CHU Rangueil (N.K.); CHU Purpan (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Erasmus MC (B.C.J.), University Medical Centre Rotterdam; and Department of Neurology (N.v.A., B.G.M.v.E.), Donders Center for Medical Neuroscience, Radboudumc Nijmegen, the Netherlands., Kuntzer T; From the Jeroen Bosch Hospital (J.J.J.v.E.), 's-Hertogenbosch, the Netherlands; Royal Cornwall Hospital (H.R.D., R.G.M., C.J., J. Herrod, R.F.L., H.H.A., M.A., O.A.B.A.L.M., B.N.M., R.P.B.); European Centre for the Environment and Human Health (H.R.D., R.P.B.), University of Exeter, Truro, UK; Neurocenter of Southern Switzerland (P.R., C.G., G.M.), Lugano; Department of Neurology and Neuroscience (M.F.) and Institute for Virology (M.P.), Medical Center-University of Freiburg and Faculty of Medicine, University of Freiburg, Germany; Microbiology Department (E.P.), EOLAB (SMIC), Bellinzona, Switzerland; University Hospital Lausanne (CHUV) (M.F., D.B., T.K., V.A., R.S., D.M.), Switzerland; Université Paul Sabatier (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Centre Hospitalo-Universitaire Timone (S.A., R.G., P.C.); IHU-Méditerranée Infection (P.C.), Aix-Marseille Université, AP-HM, France; San Bortolo Hospital (M.T.G.), Vicenza, Italy; University Medical Center Hamburg-Eppendorf (J. Hartl, S.P.), Germany; Northumbria University (N.X.L.), Newcastle upon Tyne, UK; CHU Rangueil (N.K.); CHU Purpan (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Erasmus MC (B.C.J.), University Medical Centre Rotterdam; and Department of Neurology (N.v.A., B.G.M.v.E.), Donders Center for Medical Neuroscience, Radboudumc Nijmegen, the Netherlands., Aubert V; From the Jeroen Bosch Hospital (J.J.J.v.E.), 's-Hertogenbosch, the Netherlands; Royal Cornwall Hospital (H.R.D., R.G.M., C.J., J. Herrod, R.F.L., H.H.A., M.A., O.A.B.A.L.M., B.N.M., R.P.B.); European Centre for the Environment and Human Health (H.R.D., R.P.B.), University of Exeter, Truro, UK; Neurocenter of Southern Switzerland (P.R., C.G., G.M.), Lugano; Department of Neurology and Neuroscience (M.F.) and Institute for Virology (M.P.), Medical Center-University of Freiburg and Faculty of Medicine, University of Freiburg, Germany; Microbiology Department (E.P.), EOLAB (SMIC), Bellinzona, Switzerland; University Hospital Lausanne (CHUV) (M.F., D.B., T.K., V.A., R.S., D.M.), Switzerland; Université Paul Sabatier (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Centre Hospitalo-Universitaire Timone (S.A., R.G., P.C.); IHU-Méditerranée Infection (P.C.), Aix-Marseille Université, AP-HM, France; San Bortolo Hospital (M.T.G.), Vicenza, Italy; University Medical Center Hamburg-Eppendorf (J. Hartl, S.P.), Germany; Northumbria University (N.X.L.), Newcastle upon Tyne, UK; CHU Rangueil (N.K.); CHU Purpan (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Erasmus MC (B.C.J.), University Medical Centre Rotterdam; and Department of Neurology (N.v.A., B.G.M.v.E.), Donders Center for Medical Neuroscience, Radboudumc Nijmegen, the Netherlands., Sahli R; From the Jeroen Bosch Hospital (J.J.J.v.E.), 's-Hertogenbosch, the Netherlands; Royal Cornwall Hospital (H.R.D., R.G.M., C.J., J. Herrod, R.F.L., H.H.A., M.A., O.A.B.A.L.M., B.N.M., R.P.B.); European Centre for the Environment and Human Health (H.R.D., R.P.B.), University of Exeter, Truro, UK; Neurocenter of Southern Switzerland (P.R., C.G., G.M.), Lugano; Department of Neurology and Neuroscience (M.F.) and Institute for Virology (M.P.), Medical Center-University of Freiburg and Faculty of Medicine, University of Freiburg, Germany; Microbiology Department (E.P.), EOLAB (SMIC), Bellinzona, Switzerland; University Hospital Lausanne (CHUV) (M.F., D.B., T.K., V.A., R.S., D.M.), Switzerland; Université Paul Sabatier (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Centre Hospitalo-Universitaire Timone (S.A., R.G., P.C.); IHU-Méditerranée Infection (P.C.), Aix-Marseille Université, AP-HM, France; San Bortolo Hospital (M.T.G.), Vicenza, Italy; University Medical Center Hamburg-Eppendorf (J. Hartl, S.P.), Germany; Northumbria University (N.X.L.), Newcastle upon Tyne, UK; CHU Rangueil (N.K.); CHU Purpan (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Erasmus MC (B.C.J.), University Medical Centre Rotterdam; and Department of Neurology (N.v.A., B.G.M.v.E.), Donders Center for Medical Neuroscience, Radboudumc Nijmegen, the Netherlands., Moradpour D; From the Jeroen Bosch Hospital (J.J.J.v.E.), 's-Hertogenbosch, the Netherlands; Royal Cornwall Hospital (H.R.D., R.G.M., C.J., J. Herrod, R.F.L., H.H.A., M.A., O.A.B.A.L.M., B.N.M., R.P.B.); European Centre for the Environment and Human Health (H.R.D., R.P.B.), University of Exeter, Truro, UK; Neurocenter of Southern Switzerland (P.R., C.G., G.M.), Lugano; Department of Neurology and Neuroscience (M.F.) and Institute for Virology (M.P.), Medical Center-University of Freiburg and Faculty of Medicine, University of Freiburg, Germany; Microbiology Department (E.P.), EOLAB (SMIC), Bellinzona, Switzerland; University Hospital Lausanne (CHUV) (M.F., D.B., T.K., V.A., R.S., D.M.), Switzerland; Université Paul Sabatier (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Centre Hospitalo-Universitaire Timone (S.A., R.G., P.C.); IHU-Méditerranée Infection (P.C.), Aix-Marseille Université, AP-HM, France; San Bortolo Hospital (M.T.G.), Vicenza, Italy; University Medical Center Hamburg-Eppendorf (J. Hartl, S.P.), Germany; Northumbria University (N.X.L.), Newcastle upon Tyne, UK; CHU Rangueil (N.K.); CHU Purpan (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Erasmus MC (B.C.J.), University Medical Centre Rotterdam; and Department of Neurology (N.v.A., B.G.M.v.E.), Donders Center for Medical Neuroscience, Radboudumc Nijmegen, the Netherlands., Blasco-Perrin H; From the Jeroen Bosch Hospital (J.J.J.v.E.), 's-Hertogenbosch, the Netherlands; Royal Cornwall Hospital (H.R.D., R.G.M., C.J., J. Herrod, R.F.L., H.H.A., M.A., O.A.B.A.L.M., B.N.M., R.P.B.); European Centre for the Environment and Human Health (H.R.D., R.P.B.), University of Exeter, Truro, UK; Neurocenter of Southern Switzerland (P.R., C.G., G.M.), Lugano; Department of Neurology and Neuroscience (M.F.) and Institute for Virology (M.P.), Medical Center-University of Freiburg and Faculty of Medicine, University of Freiburg, Germany; Microbiology Department (E.P.), EOLAB (SMIC), Bellinzona, Switzerland; University Hospital Lausanne (CHUV) (M.F., D.B., T.K., V.A., R.S., D.M.), Switzerland; Université Paul Sabatier (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Centre Hospitalo-Universitaire Timone (S.A., R.G., P.C.); IHU-Méditerranée Infection (P.C.), Aix-Marseille Université, AP-HM, France; San Bortolo Hospital (M.T.G.), Vicenza, Italy; University Medical Center Hamburg-Eppendorf (J. Hartl, S.P.), Germany; Northumbria University (N.X.L.), Newcastle upon Tyne, UK; CHU Rangueil (N.K.); CHU Purpan (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Erasmus MC (B.C.J.), University Medical Centre Rotterdam; and Department of Neurology (N.v.A., B.G.M.v.E.), Donders Center for Medical Neuroscience, Radboudumc Nijmegen, the Netherlands., Attarian S; From the Jeroen Bosch Hospital (J.J.J.v.E.), 's-Hertogenbosch, the Netherlands; Royal Cornwall Hospital (H.R.D., R.G.M., C.J., J. Herrod, R.F.L., H.H.A., M.A., O.A.B.A.L.M., B.N.M., R.P.B.); European Centre for the Environment and Human Health (H.R.D., R.P.B.), University of Exeter, Truro, UK; Neurocenter of Southern Switzerland (P.R., C.G., G.M.), Lugano; Department of Neurology and Neuroscience (M.F.) and Institute for Virology (M.P.), Medical Center-University of Freiburg and Faculty of Medicine, University of Freiburg, Germany; Microbiology Department (E.P.), EOLAB (SMIC), Bellinzona, Switzerland; University Hospital Lausanne (CHUV) (M.F., D.B., T.K., V.A., R.S., D.M.), Switzerland; Université Paul Sabatier (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Centre Hospitalo-Universitaire Timone (S.A., R.G., P.C.); IHU-Méditerranée Infection (P.C.), Aix-Marseille Université, AP-HM, France; San Bortolo Hospital (M.T.G.), Vicenza, Italy; University Medical Center Hamburg-Eppendorf (J. Hartl, S.P.), Germany; Northumbria University (N.X.L.), Newcastle upon Tyne, UK; CHU Rangueil (N.K.); CHU Purpan (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Erasmus MC (B.C.J.), University Medical Centre Rotterdam; and Department of Neurology (N.v.A., B.G.M.v.E.), Donders Center for Medical Neuroscience, Radboudumc Nijmegen, the Netherlands., Gérolami R; From the Jeroen Bosch Hospital (J.J.J.v.E.), 's-Hertogenbosch, the Netherlands; Royal Cornwall Hospital (H.R.D., R.G.M., C.J., J. Herrod, R.F.L., H.H.A., M.A., O.A.B.A.L.M., B.N.M., R.P.B.); European Centre for the Environment and Human Health (H.R.D., R.P.B.), University of Exeter, Truro, UK; Neurocenter of Southern Switzerland (P.R., C.G., G.M.), Lugano; Department of Neurology and Neuroscience (M.F.) and Institute for Virology (M.P.), Medical Center-University of Freiburg and Faculty of Medicine, University of Freiburg, Germany; Microbiology Department (E.P.), EOLAB (SMIC), Bellinzona, Switzerland; University Hospital Lausanne (CHUV) (M.F., D.B., T.K., V.A., R.S., D.M.), Switzerland; Université Paul Sabatier (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Centre Hospitalo-Universitaire Timone (S.A., R.G., P.C.); IHU-Méditerranée Infection (P.C.), Aix-Marseille Université, AP-HM, France; San Bortolo Hospital (M.T.G.), Vicenza, Italy; University Medical Center Hamburg-Eppendorf (J. Hartl, S.P.), Germany; Northumbria University (N.X.L.), Newcastle upon Tyne, UK; CHU Rangueil (N.K.); CHU Purpan (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Erasmus MC (B.C.J.), University Medical Centre Rotterdam; and Department of Neurology (N.v.A., B.G.M.v.E.), Donders Center for Medical Neuroscience, Radboudumc Nijmegen, the Netherlands., Colson P; From the Jeroen Bosch Hospital (J.J.J.v.E.), 's-Hertogenbosch, the Netherlands; Royal Cornwall Hospital (H.R.D., R.G.M., C.J., J. Herrod, R.F.L., H.H.A., M.A., O.A.B.A.L.M., B.N.M., R.P.B.); European Centre for the Environment and Human Health (H.R.D., R.P.B.), University of Exeter, Truro, UK; Neurocenter of Southern Switzerland (P.R., C.G., G.M.), Lugano; Department of Neurology and Neuroscience (M.F.) and Institute for Virology (M.P.), Medical Center-University of Freiburg and Faculty of Medicine, University of Freiburg, Germany; Microbiology Department (E.P.), EOLAB (SMIC), Bellinzona, Switzerland; University Hospital Lausanne (CHUV) (M.F., D.B., T.K., V.A., R.S., D.M.), Switzerland; Université Paul Sabatier (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Centre Hospitalo-Universitaire Timone (S.A., R.G., P.C.); IHU-Méditerranée Infection (P.C.), Aix-Marseille Université, AP-HM, France; San Bortolo Hospital (M.T.G.), Vicenza, Italy; University Medical Center Hamburg-Eppendorf (J. Hartl, S.P.), Germany; Northumbria University (N.X.L.), Newcastle upon Tyne, UK; CHU Rangueil (N.K.); CHU Purpan (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Erasmus MC (B.C.J.), University Medical Centre Rotterdam; and Department of Neurology (N.v.A., B.G.M.v.E.), Donders Center for Medical Neuroscience, Radboudumc Nijmegen, the Netherlands., Giordani MT; From the Jeroen Bosch Hospital (J.J.J.v.E.), 's-Hertogenbosch, the Netherlands; Royal Cornwall Hospital (H.R.D., R.G.M., C.J., J. Herrod, R.F.L., H.H.A., M.A., O.A.B.A.L.M., B.N.M., R.P.B.); European Centre for the Environment and Human Health (H.R.D., R.P.B.), University of Exeter, Truro, UK; Neurocenter of Southern Switzerland (P.R., C.G., G.M.), Lugano; Department of Neurology and Neuroscience (M.F.) and Institute for Virology (M.P.), Medical Center-University of Freiburg and Faculty of Medicine, University of Freiburg, Germany; Microbiology Department (E.P.), EOLAB (SMIC), Bellinzona, Switzerland; University Hospital Lausanne (CHUV) (M.F., D.B., T.K., V.A., R.S., D.M.), Switzerland; Université Paul Sabatier (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Centre Hospitalo-Universitaire Timone (S.A., R.G., P.C.); IHU-Méditerranée Infection (P.C.), Aix-Marseille Université, AP-HM, France; San Bortolo Hospital (M.T.G.), Vicenza, Italy; University Medical Center Hamburg-Eppendorf (J. Hartl, S.P.), Germany; Northumbria University (N.X.L.), Newcastle upon Tyne, UK; CHU Rangueil (N.K.); CHU Purpan (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Erasmus MC (B.C.J.), University Medical Centre Rotterdam; and Department of Neurology (N.v.A., B.G.M.v.E.), Donders Center for Medical Neuroscience, Radboudumc Nijmegen, the Netherlands., Hartl J; From the Jeroen Bosch Hospital (J.J.J.v.E.), 's-Hertogenbosch, the Netherlands; Royal Cornwall Hospital (H.R.D., R.G.M., C.J., J. Herrod, R.F.L., H.H.A., M.A., O.A.B.A.L.M., B.N.M., R.P.B.); European Centre for the Environment and Human Health (H.R.D., R.P.B.), University of Exeter, Truro, UK; Neurocenter of Southern Switzerland (P.R., C.G., G.M.), Lugano; Department of Neurology and Neuroscience (M.F.) and Institute for Virology (M.P.), Medical Center-University of Freiburg and Faculty of Medicine, University of Freiburg, Germany; Microbiology Department (E.P.), EOLAB (SMIC), Bellinzona, Switzerland; University Hospital Lausanne (CHUV) (M.F., D.B., T.K., V.A., R.S., D.M.), Switzerland; Université Paul Sabatier (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Centre Hospitalo-Universitaire Timone (S.A., R.G., P.C.); IHU-Méditerranée Infection (P.C.), Aix-Marseille Université, AP-HM, France; San Bortolo Hospital (M.T.G.), Vicenza, Italy; University Medical Center Hamburg-Eppendorf (J. Hartl, S.P.), Germany; Northumbria University (N.X.L.), Newcastle upon Tyne, UK; CHU Rangueil (N.K.); CHU Purpan (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Erasmus MC (B.C.J.), University Medical Centre Rotterdam; and Department of Neurology (N.v.A., B.G.M.v.E.), Donders Center for Medical Neuroscience, Radboudumc Nijmegen, the Netherlands., Pischke S; From the Jeroen Bosch Hospital (J.J.J.v.E.), 's-Hertogenbosch, the Netherlands; Royal Cornwall Hospital (H.R.D., R.G.M., C.J., J. Herrod, R.F.L., H.H.A., M.A., O.A.B.A.L.M., B.N.M., R.P.B.); European Centre for the Environment and Human Health (H.R.D., R.P.B.), University of Exeter, Truro, UK; Neurocenter of Southern Switzerland (P.R., C.G., G.M.), Lugano; Department of Neurology and Neuroscience (M.F.) and Institute for Virology (M.P.), Medical Center-University of Freiburg and Faculty of Medicine, University of Freiburg, Germany; Microbiology Department (E.P.), EOLAB (SMIC), Bellinzona, Switzerland; University Hospital Lausanne (CHUV) (M.F., D.B., T.K., V.A., R.S., D.M.), Switzerland; Université Paul Sabatier (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Centre Hospitalo-Universitaire Timone (S.A., R.G., P.C.); IHU-Méditerranée Infection (P.C.), Aix-Marseille Université, AP-HM, France; San Bortolo Hospital (M.T.G.), Vicenza, Italy; University Medical Center Hamburg-Eppendorf (J. Hartl, S.P.), Germany; Northumbria University (N.X.L.), Newcastle upon Tyne, UK; CHU Rangueil (N.K.); CHU Purpan (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Erasmus MC (B.C.J.), University Medical Centre Rotterdam; and Department of Neurology (N.v.A., B.G.M.v.E.), Donders Center for Medical Neuroscience, Radboudumc Nijmegen, the Netherlands., Lin NX; From the Jeroen Bosch Hospital (J.J.J.v.E.), 's-Hertogenbosch, the Netherlands; Royal Cornwall Hospital (H.R.D., R.G.M., C.J., J. Herrod, R.F.L., H.H.A., M.A., O.A.B.A.L.M., B.N.M., R.P.B.); European Centre for the Environment and Human Health (H.R.D., R.P.B.), University of Exeter, Truro, UK; Neurocenter of Southern Switzerland (P.R., C.G., G.M.), Lugano; Department of Neurology and Neuroscience (M.F.) and Institute for Virology (M.P.), Medical Center-University of Freiburg and Faculty of Medicine, University of Freiburg, Germany; Microbiology Department (E.P.), EOLAB (SMIC), Bellinzona, Switzerland; University Hospital Lausanne (CHUV) (M.F., D.B., T.K., V.A., R.S., D.M.), Switzerland; Université Paul Sabatier (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Centre Hospitalo-Universitaire Timone (S.A., R.G., P.C.); IHU-Méditerranée Infection (P.C.), Aix-Marseille Université, AP-HM, France; San Bortolo Hospital (M.T.G.), Vicenza, Italy; University Medical Center Hamburg-Eppendorf (J. Hartl, S.P.), Germany; Northumbria University (N.X.L.), Newcastle upon Tyne, UK; CHU Rangueil (N.K.); CHU Purpan (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Erasmus MC (B.C.J.), University Medical Centre Rotterdam; and Department of Neurology (N.v.A., B.G.M.v.E.), Donders Center for Medical Neuroscience, Radboudumc Nijmegen, the Netherlands., Mclean BN; From the Jeroen Bosch Hospital (J.J.J.v.E.), 's-Hertogenbosch, the Netherlands; Royal Cornwall Hospital (H.R.D., R.G.M., C.J., J. Herrod, R.F.L., H.H.A., M.A., O.A.B.A.L.M., B.N.M., R.P.B.); European Centre for the Environment and Human Health (H.R.D., R.P.B.), University of Exeter, Truro, UK; Neurocenter of Southern Switzerland (P.R., C.G., G.M.), Lugano; Department of Neurology and Neuroscience (M.F.) and Institute for Virology (M.P.), Medical Center-University of Freiburg and Faculty of Medicine, University of Freiburg, Germany; Microbiology Department (E.P.), EOLAB (SMIC), Bellinzona, Switzerland; University Hospital Lausanne (CHUV) (M.F., D.B., T.K., V.A., R.S., D.M.), Switzerland; Université Paul Sabatier (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Centre Hospitalo-Universitaire Timone (S.A., R.G., P.C.); IHU-Méditerranée Infection (P.C.), Aix-Marseille Université, AP-HM, France; San Bortolo Hospital (M.T.G.), Vicenza, Italy; University Medical Center Hamburg-Eppendorf (J. Hartl, S.P.), Germany; Northumbria University (N.X.L.), Newcastle upon Tyne, UK; CHU Rangueil (N.K.); CHU Purpan (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Erasmus MC (B.C.J.), University Medical Centre Rotterdam; and Department of Neurology (N.v.A., B.G.M.v.E.), Donders Center for Medical Neuroscience, Radboudumc Nijmegen, the Netherlands., Bendall RP; From the Jeroen Bosch Hospital (J.J.J.v.E.), 's-Hertogenbosch, the Netherlands; Royal Cornwall Hospital (H.R.D., R.G.M., C.J., J. Herrod, R.F.L., H.H.A., M.A., O.A.B.A.L.M., B.N.M., R.P.B.); European Centre for the Environment and Human Health (H.R.D., R.P.B.), University of Exeter, Truro, UK; Neurocenter of Southern Switzerland (P.R., C.G., G.M.), Lugano; Department of Neurology and Neuroscience (M.F.) and Institute for Virology (M.P.), Medical Center-University of Freiburg and Faculty of Medicine, University of Freiburg, Germany; Microbiology Department (E.P.), EOLAB (SMIC), Bellinzona, Switzerland; University Hospital Lausanne (CHUV) (M.F., D.B., T.K., V.A., R.S., D.M.), Switzerland; Université Paul Sabatier (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Centre Hospitalo-Universitaire Timone (S.A., R.G., P.C.); IHU-Méditerranée Infection (P.C.), Aix-Marseille Université, AP-HM, France; San Bortolo Hospital (M.T.G.), Vicenza, Italy; University Medical Center Hamburg-Eppendorf (J. Hartl, S.P.), Germany; Northumbria University (N.X.L.), Newcastle upon Tyne, UK; CHU Rangueil (N.K.); CHU Purpan (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Erasmus MC (B.C.J.), University Medical Centre Rotterdam; and Department of Neurology (N.v.A., B.G.M.v.E.), Donders Center for Medical Neuroscience, Radboudumc Nijmegen, the Netherlands., Panning M; From the Jeroen Bosch Hospital (J.J.J.v.E.), 's-Hertogenbosch, the Netherlands; Royal Cornwall Hospital (H.R.D., R.G.M., C.J., J. Herrod, R.F.L., H.H.A., M.A., O.A.B.A.L.M., B.N.M., R.P.B.); European Centre for the Environment and Human Health (H.R.D., R.P.B.), University of Exeter, Truro, UK; Neurocenter of Southern Switzerland (P.R., C.G., G.M.), Lugano; Department of Neurology and Neuroscience (M.F.) and Institute for Virology (M.P.), Medical Center-University of Freiburg and Faculty of Medicine, University of Freiburg, Germany; Microbiology Department (E.P.), EOLAB (SMIC), Bellinzona, Switzerland; University Hospital Lausanne (CHUV) (M.F., D.B., T.K., V.A., R.S., D.M.), Switzerland; Université Paul Sabatier (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Centre Hospitalo-Universitaire Timone (S.A., R.G., P.C.); IHU-Méditerranée Infection (P.C.), Aix-Marseille Université, AP-HM, France; San Bortolo Hospital (M.T.G.), Vicenza, Italy; University Medical Center Hamburg-Eppendorf (J. Hartl, S.P.), Germany; Northumbria University (N.X.L.), Newcastle upon Tyne, UK; CHU Rangueil (N.K.); CHU Purpan (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Erasmus MC (B.C.J.), University Medical Centre Rotterdam; and Department of Neurology (N.v.A., B.G.M.v.E.), Donders Center for Medical Neuroscience, Radboudumc Nijmegen, the Netherlands., Peron JM; From the Jeroen Bosch Hospital (J.J.J.v.E.), 's-Hertogenbosch, the Netherlands; Royal Cornwall Hospital (H.R.D., R.G.M., C.J., J. Herrod, R.F.L., H.H.A., M.A., O.A.B.A.L.M., B.N.M., R.P.B.); European Centre for the Environment and Human Health (H.R.D., R.P.B.), University of Exeter, Truro, UK; Neurocenter of Southern Switzerland (P.R., C.G., G.M.), Lugano; Department of Neurology and Neuroscience (M.F.) and Institute for Virology (M.P.), Medical Center-University of Freiburg and Faculty of Medicine, University of Freiburg, Germany; Microbiology Department (E.P.), EOLAB (SMIC), Bellinzona, Switzerland; University Hospital Lausanne (CHUV) (M.F., D.B., T.K., V.A., R.S., D.M.), Switzerland; Université Paul Sabatier (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Centre Hospitalo-Universitaire Timone (S.A., R.G., P.C.); IHU-Méditerranée Infection (P.C.), Aix-Marseille Université, AP-HM, France; San Bortolo Hospital (M.T.G.), Vicenza, Italy; University Medical Center Hamburg-Eppendorf (J. Hartl, S.P.), Germany; Northumbria University (N.X.L.), Newcastle upon Tyne, UK; CHU Rangueil (N.K.); CHU Purpan (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Erasmus MC (B.C.J.), University Medical Centre Rotterdam; and Department of Neurology (N.v.A., B.G.M.v.E.), Donders Center for Medical Neuroscience, Radboudumc Nijmegen, the Netherlands., Kamar N; From the Jeroen Bosch Hospital (J.J.J.v.E.), 's-Hertogenbosch, the Netherlands; Royal Cornwall Hospital (H.R.D., R.G.M., C.J., J. Herrod, R.F.L., H.H.A., M.A., O.A.B.A.L.M., B.N.M., R.P.B.); European Centre for the Environment and Human Health (H.R.D., R.P.B.), University of Exeter, Truro, UK; Neurocenter of Southern Switzerland (P.R., C.G., G.M.), Lugano; Department of Neurology and Neuroscience (M.F.) and Institute for Virology (M.P.), Medical Center-University of Freiburg and Faculty of Medicine, University of Freiburg, Germany; Microbiology Department (E.P.), EOLAB (SMIC), Bellinzona, Switzerland; University Hospital Lausanne (CHUV) (M.F., D.B., T.K., V.A., R.S., D.M.), Switzerland; Université Paul Sabatier (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Centre Hospitalo-Universitaire Timone (S.A., R.G., P.C.); IHU-Méditerranée Infection (P.C.), Aix-Marseille Université, AP-HM, France; San Bortolo Hospital (M.T.G.), Vicenza, Italy; University Medical Center Hamburg-Eppendorf (J. Hartl, S.P.), Germany; Northumbria University (N.X.L.), Newcastle upon Tyne, UK; CHU Rangueil (N.K.); CHU Purpan (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Erasmus MC (B.C.J.), University Medical Centre Rotterdam; and Department of Neurology (N.v.A., B.G.M.v.E.), Donders Center for Medical Neuroscience, Radboudumc Nijmegen, the Netherlands., Izopet J; From the Jeroen Bosch Hospital (J.J.J.v.E.), 's-Hertogenbosch, the Netherlands; Royal Cornwall Hospital (H.R.D., R.G.M., C.J., J. Herrod, R.F.L., H.H.A., M.A., O.A.B.A.L.M., B.N.M., R.P.B.); European Centre for the Environment and Human Health (H.R.D., R.P.B.), University of Exeter, Truro, UK; Neurocenter of Southern Switzerland (P.R., C.G., G.M.), Lugano; Department of Neurology and Neuroscience (M.F.) and Institute for Virology (M.P.), Medical Center-University of Freiburg and Faculty of Medicine, University of Freiburg, Germany; Microbiology Department (E.P.), EOLAB (SMIC), Bellinzona, Switzerland; University Hospital Lausanne (CHUV) (M.F., D.B., T.K., V.A., R.S., D.M.), Switzerland; Université Paul Sabatier (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Centre Hospitalo-Universitaire Timone (S.A., R.G., P.C.); IHU-Méditerranée Infection (P.C.), Aix-Marseille Université, AP-HM, France; San Bortolo Hospital (M.T.G.), Vicenza, Italy; University Medical Center Hamburg-Eppendorf (J. Hartl, S.P.), Germany; Northumbria University (N.X.L.), Newcastle upon Tyne, UK; CHU Rangueil (N.K.); CHU Purpan (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Erasmus MC (B.C.J.), University Medical Centre Rotterdam; and Department of Neurology (N.v.A., B.G.M.v.E.), Donders Center for Medical Neuroscience, Radboudumc Nijmegen, the Netherlands., Jacobs BC; From the Jeroen Bosch Hospital (J.J.J.v.E.), 's-Hertogenbosch, the Netherlands; Royal Cornwall Hospital (H.R.D., R.G.M., C.J., J. Herrod, R.F.L., H.H.A., M.A., O.A.B.A.L.M., B.N.M., R.P.B.); European Centre for the Environment and Human Health (H.R.D., R.P.B.), University of Exeter, Truro, UK; Neurocenter of Southern Switzerland (P.R., C.G., G.M.), Lugano; Department of Neurology and Neuroscience (M.F.) and Institute for Virology (M.P.), Medical Center-University of Freiburg and Faculty of Medicine, University of Freiburg, Germany; Microbiology Department (E.P.), EOLAB (SMIC), Bellinzona, Switzerland; University Hospital Lausanne (CHUV) (M.F., D.B., T.K., V.A., R.S., D.M.), Switzerland; Université Paul Sabatier (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Centre Hospitalo-Universitaire Timone (S.A., R.G., P.C.); IHU-Méditerranée Infection (P.C.), Aix-Marseille Université, AP-HM, France; San Bortolo Hospital (M.T.G.), Vicenza, Italy; University Medical Center Hamburg-Eppendorf (J. Hartl, S.P.), Germany; Northumbria University (N.X.L.), Newcastle upon Tyne, UK; CHU Rangueil (N.K.); CHU Purpan (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Erasmus MC (B.C.J.), University Medical Centre Rotterdam; and Department of Neurology (N.v.A., B.G.M.v.E.), Donders Center for Medical Neuroscience, Radboudumc Nijmegen, the Netherlands., van Alfen N; From the Jeroen Bosch Hospital (J.J.J.v.E.), 's-Hertogenbosch, the Netherlands; Royal Cornwall Hospital (H.R.D., R.G.M., C.J., J. Herrod, R.F.L., H.H.A., M.A., O.A.B.A.L.M., B.N.M., R.P.B.); European Centre for the Environment and Human Health (H.R.D., R.P.B.), University of Exeter, Truro, UK; Neurocenter of Southern Switzerland (P.R., C.G., G.M.), Lugano; Department of Neurology and Neuroscience (M.F.) and Institute for Virology (M.P.), Medical Center-University of Freiburg and Faculty of Medicine, University of Freiburg, Germany; Microbiology Department (E.P.), EOLAB (SMIC), Bellinzona, Switzerland; University Hospital Lausanne (CHUV) (M.F., D.B., T.K., V.A., R.S., D.M.), Switzerland; Université Paul Sabatier (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Centre Hospitalo-Universitaire Timone (S.A., R.G., P.C.); IHU-Méditerranée Infection (P.C.), Aix-Marseille Université, AP-HM, France; San Bortolo Hospital (M.T.G.), Vicenza, Italy; University Medical Center Hamburg-Eppendorf (J. Hartl, S.P.), Germany; Northumbria University (N.X.L.), Newcastle upon Tyne, UK; CHU Rangueil (N.K.); CHU Purpan (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Erasmus MC (B.C.J.), University Medical Centre Rotterdam; and Department of Neurology (N.v.A., B.G.M.v.E.), Donders Center for Medical Neuroscience, Radboudumc Nijmegen, the Netherlands., van Engelen BGM; From the Jeroen Bosch Hospital (J.J.J.v.E.), 's-Hertogenbosch, the Netherlands; Royal Cornwall Hospital (H.R.D., R.G.M., C.J., J. Herrod, R.F.L., H.H.A., M.A., O.A.B.A.L.M., B.N.M., R.P.B.); European Centre for the Environment and Human Health (H.R.D., R.P.B.), University of Exeter, Truro, UK; Neurocenter of Southern Switzerland (P.R., C.G., G.M.), Lugano; Department of Neurology and Neuroscience (M.F.) and Institute for Virology (M.P.), Medical Center-University of Freiburg and Faculty of Medicine, University of Freiburg, Germany; Microbiology Department (E.P.), EOLAB (SMIC), Bellinzona, Switzerland; University Hospital Lausanne (CHUV) (M.F., D.B., T.K., V.A., R.S., D.M.), Switzerland; Université Paul Sabatier (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Centre Hospitalo-Universitaire Timone (S.A., R.G., P.C.); IHU-Méditerranée Infection (P.C.), Aix-Marseille Université, AP-HM, France; San Bortolo Hospital (M.T.G.), Vicenza, Italy; University Medical Center Hamburg-Eppendorf (J. Hartl, S.P.), Germany; Northumbria University (N.X.L.), Newcastle upon Tyne, UK; CHU Rangueil (N.K.); CHU Purpan (H.B.-P., J.-M.P., N.K., J.I.), Toulouse, France; Erasmus MC (B.C.J.), University Medical Centre Rotterdam; and Department of Neurology (N.v.A., B.G.M.v.E.), Donders Center for Medical Neuroscience, Radboudumc Nijmegen, the Netherlands.
Jazyk:	angličtina
Zdroj:	Neurology [Neurology] 2017 Aug 29; Vol. 89 (9), pp. 909-917. Date of Electronic Publication: 2017 Aug 02.
DOI:	10.1212/WNL.0000000000004297
Abstrakt:	Objective: To determine the clinical phenotype and outcome in hepatitis E virus-associated neuralgic amyotrophy (HEV-NA). Methods: Cases of NA were identified in 11 centers from 7 European countries, with retrospective analysis of demographics, clinical/laboratory findings, and treatment and outcome. Cases of HEV-NA were compared with NA cases without evidence of HEV infection. Results: Fifty-seven cases of HEV-NA and 61 NA cases without HEV were studied. Fifty-six of 57 HEV-NA cases were anti-HEV IgM positive; 53/57 were IgG positive. In 38 cases, HEV RNA was recovered from the serum and in 1 from the CSF (all genotype 3). Fifty-one of 57 HEV-NA cases were anicteric; median alanine aminotransferase 259 IU/L (range 12-2,961 IU/L); in 6 cases, liver function tests were normal. HEV-NA cases were more likely to have bilateral involvement (80.0% vs 8.6%, p < 0.001), damage outside the brachial plexus (58.5% vs 10.5%, p < 0.01), including phrenic nerve and lumbosacral plexus injury (25.0% vs 3.5%, p = 0.01, and 26.4% vs 7.0%, p = 0.001), reduced reflexes ( p = 0.03), sensory symptoms ( p = 0.04) with more extensive damage to the brachial plexus. There was no difference in outcome between the 2 groups at 12 months. Conclusions: Patients with HEV-NA are usually anicteric and have a distinct clinical phenotype, with predominately bilateral asymmetrical involvement of, and more extensive damage to, the brachial plexus. Involvement outside the brachial plexus is more common in HEV-NA. The relationship between HEV and NA is likely to be causal, but is easily overlooked. Patients presenting with NA should be tested for HEV, irrespective of liver function test results. Prospective treatment/outcome studies of HEV-NA are warranted. (© 2017 American Academy of Neurology.)
Databáze:	MEDLINE
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