title: [A young patient of acute encephalitis complicated with acyclovir encephalopathy without renal dysfunction].
abstract: A previously healthy 30-year-old woman was admitted to our hospital because of impaired consciousness after convulsion. A temporary diagnosis of herpes simplex encephalitis was made, and intravenous acyclovir (ACV) therapy (250 mg four times daily in normal saline over 2 hours) was started. Three days later, she became confused, and was having hallucinations, dysarthria and generalized painful seizures occurred without focal neurologic deficit. Whether the neuropsychiatric symptoms were related to herpes simplex encephalitis or acyclovir neurotoxity was initially unclear. The brain MRI and lumbar puncture findings were initially normal, but abnormal FLAIR lesions appeared later. ACV-associated encephalopathy was considered. ACV was discontinued, and she recovered from the neurological disorder within 24 hours. Although blood levels of acyclovir were not determined, it is unlikely that they were in a toxic range, in view of her normal renal function.
authors.affiliation: Department of Neurology, Ashikaga Red Cross Hospital.
authors.forename: Koji
authors.initials: K
authors.lastname: Tomori
authors.forename: Kazuo
authors.initials: K
authors.lastname: Isozumi
authors.forename: Sachiko
authors.initials: S
authors.lastname: Motohashi
authors.forename: Satoru
authors.initials: S
authors.lastname: Komatsumoto
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Fukuuchi
mesh_terms: D000208:Acute Disease; D000212:Acyclovir / Q000009:adverse effects*; D000328:Adult; D000998:Antiviral Agents / Q000009:adverse effects*; D001927:Brain Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000523:psychology*; D004401:Dysarthria / Q000139:chemically induced; D018792:Encephalitis, Viral / Q000188:drug therapy*; D004829:Epilepsy, Generalized / Q000139:chemically induced; D005260:Female; D006212:Hallucinations / Q000139:chemically induced; D006801:Humans; D007674:Kidney Diseases; D008279:Magnetic Resonance Imaging
chemical_list: D000998:Antiviral Agents; D000212:Acyclovir