Movement disorder following herpes simplex encephalitis.
Two children, an eight-year-old girl and a seven-month-old boy, recovered from herpes simplex encephalitis with minimal neurological residua following acyclovir treatment. Subsequently, they experienced marked deterioration, interpreted as either recrudescent infection or a post-infectious phenomenon. Features of the deterioration included encephalopathy and hyperkinetic movement disorder. MRI studies showed extensive neocortical damage, without involvement of the basal ganglia, thalamus or subthalamic nuclei. With aggressive supportive care, both children made a slow, steady recovery over several months. This supportive care is best provided in a closely supervised interdisciplinary setting.
Shanks
D E
DE
Department of Pediatrics, University of Virginia Medical Center, Charlottesville 22901.
Blasco
P A
PA
Chason
D P
DP
D000212:Acyclovir / Q000008:administration & dosage; D001921:Brain / Q000473:pathology; D001925:Brain Damage, Chronic / Q000175:diagnosis / Q000188:drug therapy; D002648:Child; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004660:Encephalitis / Q000175:diagnosis* / Q000188:drug therapy; D005260:Female; D005500:Follow-Up Studies; D006561:Herpes Simplex / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D019965:Neurocognitive Disorders / Q000175:diagnosis / Q000188:drug therapy; D009460:Neurologic Examination; D009468:Neuromuscular Diseases / Q000175:diagnosis*
D000212:Acyclovir