title: [Clinical characteristics of relapsing virus encephalitis and mechanisms of relapse].
abstract: 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.
authors.affiliation: Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing 100730, China. huangyan90@yahoo.com.cn
authors.forename: Yan
authors.initials: Y
authors.lastname: Huang
authors.forename: Xiu-qin
authors.initials: XQ
authors.lastname: Liu
authors.forename: Yin-chang
authors.initials: YC
authors.lastname: Yang
authors.forename: Jing
authors.initials: J
authors.lastname: Gao
mesh_terms: 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
chemical_list: D000998:Antiviral Agents; D000212:Acyclovir