Relapse of Herpes Simplex Encephalitis

Author:

Barthez-Carpentier Marie-Anne1,Rozenberg Flore2,Dussaix Elisabeth3,Lebon Pierre2,Goudeau Alain4,Billard Catherine1,Tardieu Marc5

Affiliation:

1. Unité de Neurochirurgie-Neurologie, Centre de Pédiatrie Gatien de Clocheville, Tours

2. Laboratoires de Virologie, Hôpital Saint Vincent de Paul, Paris

3. Hôpital Bicêtre Le Kremlin Bicêtre

4. Hôpital Bretonneau,Tours

5. Service de Neurologie, Département de Pédiatrie, Hôpital Bicêtre, Le Kremlin Bicêtre, France

Abstract

We report five children who had recurrent central nervous system signs after conventional acyclovir therapy for herpes simplex encephalitis. Secondary exacerbation was characterized clinically by severe ballismic movement disorder in all five children, associated with fever, impairment of consciousness, and seizures. Biologic analysis in all children and magnetic resonance imaging and neuropathology studies of the brain in three cases were compatible with inflammatory reaction. In contrast, all viral cultures remained negative, herpes simplex virus antigen in one child and DNA tested by polymerase chain reaction in four children were undetectable in the first samples of cerebrospinal fluid during the relapse, suggesting a postinfectious, immune-mediated mechanism of relapse in these patients. (J Child Neurol 1995;10:363-367).

Publisher

SAGE Publications

Subject

Neurology (clinical),Pediatrics, Perinatology and Child Health

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