Basal ganglia involvement in a child with herpes simplex encephalitis.
Herpes simplex encephalitis (HSE) is a leading cause of sporadic, nonepidemic viral encephalitis in children and adults. We report a very rare case of HSE with involvement of bilateral thalamus, putamen, upper pons and midbrain, with development of extrapyramidal symptoms which responded to corticosteroid therapy. A 15-mth-old female baby admitted with complaint of fever for 5 days and generalised tonic clonic seizure 10 hours before admission. On clinical examination patient was drowsy, temperature was 39.4 degrees C and vitals were stable with signs of increased intracranial tension. There were no signs of meningeal irritation. Patient gradually become unconscious in the next few hours and pupils were constricted bilaterally with development of atonia in all four limbs and neck muscles. Doll's eye phenomenon was absent.
Mondal
Gobinda
G
Pediatric Intensive Care Unit, Department of Pediatrics, Medical College and Hospital, Kolkata, India. drgm1976@rediffmail.com
Kumar
Roopesh
R
Ghosh
Jayant Kumar
JK
Basu
Kaberi
K
Chatterjee
Sukanta
S
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use; D001480:Basal Ganglia Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D004359:Drug Therapy, Combination; D004569:Electroencephalography; D020803:Encephalitis, Herpes Simplex / Q000134:cerebrospinal fluid / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy*; D005260:Female; D005334:Fever / Q000175:diagnosis / Q000209:etiology; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008353:Mannitol / Q000627:therapeutic use; D010672:Phenytoin / Q000627:therapeutic use; D018570:Risk Assessment; D012640:Seizures / Q000175:diagnosis / Q000209:etiology; D012720:Severity of Illness Index; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D000998:Antiviral Agents; D008353:Mannitol; D010672:Phenytoin