[Clinical characteristics of relapsing virus encephalitis and mechanisms of relapse].
OBJECTIVE
To investigate the clinical characteristics of herpes simplex encephalitis (HSE) and to discuss the mechanism of its relapse.


METHODS
The clinical data of 6 patients with relapsing encephalitis, 4 male and 1 female, aged 14 - 49, out of 150 encephalitis cases were analyzed: 5 of them were suspected as with HSE clinically, and HSE was confirmed by pathology via biopsy in 2 of the 6 patients. The 5 patients were followed up for 2 - 6 years.


RESULTS
The duration between the onset and relapse was 1 - 26 months. Brain MRI or CT showed new lesions in the temporal lobe in 5 patients. Necropsy revealed intracellular inclusions, positive in HSV-1 antigen, in the neurons and glial cells of temporal lobe in one case. Second course of acyclovir therapy was effective in 5 of these 6 patients. One patient died 10 months later.


CONCLUSIONS
Direct invasion of activated virus into the central nervous system and insufficiency of acyclovir treatment are the causes of relapse of HSE. Acyclovir treatment should be early, with sufficient amount, and individualized.
Huang
Yan
Y
Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing 100730, China. huangyan90@yahoo.com.cn
Liu
Xiu-qin
XQ
Yang
Yin-chang
YC
Gao
Jing
J
D000212:Acyclovir / Q000627:therapeutic use*; D000293:Adolescent; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D020803:Encephalitis, Herpes Simplex / Q000188:drug therapy* / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D013702:Temporal Lobe / Q000187:drug effects / Q000473:pathology / Q000821:virology; D014057:Tomography, X-Ray Computed; D055815:Young Adult
D000998:Antiviral Agents; D000212:Acyclovir