Postinfectious immune-mediated encephalitis after pediatric herpes simplex encephalitis.
We report a 3-year-old patient who presented a secondary acute neurological deterioration clinically characterized by a partial Kluver-Bucy syndrome, 1 month after the onset of herpes simplex encephalitis. This episode is unlikely due to continuation or resumption of cerebral viral replication but might be related to an immune-inflammatory process. In children, postinfectious immune-mediated encephalitis occurring after HSE are usually clinically characterized by choreoathetoid movements. This type of movement disorder was, however, not observed in this patient. On the basis of this case and a review of the literature, we hypothesize the existence of a spectrum of secondary immune-mediated process triggered by herpes simplex virus cerebral infection ranging from asymptomatic cases with diffuse white matter involvement to secondary acute neurological deteriorations with or without extrapyramidal features.
De Tiège
Xavier
X
Department of Pediatric Neurology, ULB-Hôpital Erasme Brussels, Brussels, Belgium. xdetiege@ulb.ac.be
De Laet
Corinne
C
Mazoin
Nathalie
N
Christophe
Catherine
C
Mewasingh
Leena D
LD
Wetzburger
Catherine
C
Dan
Bernard
B
D001921:Brain / Q000276:immunology / Q000473:pathology / Q000821:virology; D002675:Child, Preschool; D020803:Encephalitis, Herpes Simplex / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D004673:Encephalomyelitis, Acute Disseminated / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D020232:Kluver-Bucy Syndrome / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008297:Male; D018139:Simplexvirus