Herpes encephalitis during natalizumab treatment in multiple sclerosis

Author:

Kwiatkowski A1,Gallois J1,Bilbault N1,Calais G1,Mackowiak A1,Hautecoeur P1

Affiliation:

1. PRES Lille Nord de France, Université Catholique de Lille, Groupe Hospitalier de l’Institut Catholique de Lille / Faculté Libre de Médecine, Clinique de Neurologie, Lille, France

Abstract

In this case report we describe the first non-fatal herpes simplex virus encephalitis (HSE) case with natalizumab for multiple sclerosis (MS). A 36-year-old woman, previously treated with immunomodulatory and immunosuppressive drugs for MS, developed acute encephalitis after 6 monthly natalizumab perfusions. Brain imaging demonstrated suggestive bi-temporal lesions. Herpes simplex virus type-1 DNA was detected in cerebrospinal fluid. The patient improved gradually after a 21-day course of intravenous acyclovir, but neuropsychiatric changes remained 5 months later. Our non-fatal case of HSE and other reported cases of herpes infections provide evidence of an increased risk with natalizumab and point to the need for clinicians to maintain awareness.

Publisher

SAGE Publications

Subject

Neurology (clinical),Neurology

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