A link from mild encephalitis to systemic pathology via CSF outflow along nerves

Karl Bechter, M.D., Ph.D.


Dr. med., PD, Professor Psychiatry



Mild encephalitis may underly a subgroup of severe mental disorders, especially from the affective and schizophrenic spectrum ( Bechter 2001 & 2013). An emerging number of recent findings support such pathophysiological considerations . Primary site of pathology appears to be the brain. However , also systemic pathology has been found. Replicated systemic findings in both schizophrenia and depression, first described by Meltzer & Crayton, were muscle lesions of a histopathological pattern known from meningoencephalitis. However, in none of these disorders the pathoanatomical pathways of these muscle lesions are known. A simple and logical explanation could represent CSF signalling via the long described CSF outflow along all nerves, which remained however completely ignored in a pathophysiological scenario up to now. We have recently described that even CSF cells can follow this peripheral CSF outflow pathway and with the recent discovery of exosomes to prevail within CSF, also exosomes and other microparticles have to be considered in such pathology scenario with important consequences in the understanding of systemic symptoms in neuroinflammation in general.