Postinfectious encephalopathy after treatment of herpes simplex encephalitis with acyclovir

Incidence and pathogenesis of clinical relapse after herpes simplex encephalitis in adults

“…Several cases of severe, lethal relapses of HSE after vidarabine or acyclovir therapy have been described, however, and often -as in our study -within two weeks to four months after the initial antiviral treatment [3][4][5][6][7][8][9][10]. Severe syndromes with choreoathetosis have been reported, particularly in children with relapsing HSE [25][26][27].…”

“…Relapse after HSE has been reported in anecdotal cases in adults [1][2][3][4][5][6] and in children [7][8][9][10]. Persistence or recurrence (reactivation) of infection with herpes simplex virus (HSV) [4][5][6] and/or immunologically mediated demyelinisation of the brain tissue [3] have been suggested as causes of clinical relapses after HSE.…”

Relapse of herpes simplex encephalitis after acyclovir therapy

“…A few cases of relapsing H S E after acyclovir treatment have also been reported and were attributed either to post-infectious encephalopathy of u n k n o w n mechanism [1,4] or to failure of the drug to eradicate the virus completely [4,5]. In our patient the time of relapse and the favourable response to the second course of acyclovir treatment strongly suggest that the first course of the 10-day treatment was not adequate for complete eradication of H S V infection.…”

“…R e l a p s e of H S E has b e e n r e p o r t e d after v i d a r a b i n e therapy [3]. F u r t h e r m o r e , in recent years a few cases of relapses following 8 [2] -1 0 [1,4,5] days of acyclovir therapy have also b e e n r e p o r t e d . W e r e p o r t a new case of clinical relapse of H S E following a 10-day course of therapy with acyclovir which r e s p o n d e d c o m p l e t e l y to a second 10-day course with the same drug.…”

HSV encephalitis-induced anti-NMDAR encephalitis in a 67-year-old woman: report of a case and review of the literature

“…Since originally reported in 1961, choreoathetosis has been recognized as a common, late symptom of HSVE relapse (De Tiége et al 2003;Ross and Stevenson 1961;Abramson et al 1984;Shanks et al 1991;Baxter et al 1994;Wang et al 1994;Schlesinger et al 1995;Hargrave and Webb 1998;Valencia et al 2004;Devrim et al 2008). Anti-NMDAR encephalitis is known to commonly present with prominent abnormal movements in children, as compared to behavioral and psychiatric changes in adults (Hacohen et al 2014;Armangue et al 2014;Dalmau et al 2008;Armangué et al 2013).…”