title: Relationship of herpes simplex encephalitis and transcranial direct current stimulation--a case report.
abstract: We report a rare case of relapsing herpes simplex encephalitis in a-37-year-old patient which was previously confirmed by positive polymerase chain reaction, herpes simplex virus (HSV) type1 IgG antibodies in cerebrospinal fluid and characterized on MRI. During the first admission, he was treated with continuous acyclovir treatment for one month with clinical improvement except for residual aphasia, for which he received a course of outpatient transcranial direct current stimulation (tDCS). A constant current of 1.2 mA was applied for 20 min twice daily. After the 4th day the patient was found to be irritable and uncooperative by staff and family members. A subsequent MRI showed significant deterioration of the lesion on comparison to the first MRI which led to discontinuation of tDCS.The relatively rapid exacerbation of HSV in only a few days is unusual. Our aim is to discuss if tDCS is related to HSV relapse and in doing so highlight possible mechanisms.
authors.affiliation: Department of Rehabilitation, Xuanwu Hospital of Capital Medical University, NO. 45, Changchun Street, Xicheng District, Beijing, China. Electronic address: duyiran0506@126.com.
authors.forename: Yuanbin
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Department of Rehabilitation, Xuanwu Hospital of Capital Medical University, NO. 45, Changchun Street, Xicheng District, Beijing, China.
authors.forename: Juan
authors.initials: J
authors.lastname: Xiao
authors.affiliation: Department of Neurology, Xuanwu Hospital of Capital Medical University, NO.45, Changchun Street, Xichen District, Beijing, China.
authors.forename: Haiqing
authors.initials: H
authors.lastname: Song
authors.affiliation: Wynscape Health and Rehabilitation and US Physiatry, 2180 Manchester Road, Wheaton, IL 60187, United States.
authors.forename: Ralph
authors.initials: R
authors.lastname: Wang
authors.affiliation: Department of Neurosurgery, Wayne State University- 4160 John R St, Ste+925, Detroit, MI 48201, USA.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Hussain
authors.affiliation: Department of Rehabilitation, China. Electronic address: songwq66@vip.163.com.
authors.forename: Weiqun
authors.initials: W
authors.lastname: Song
mesh_terms: D000212:Acyclovir / Q000008:administration & dosage / Q000627:therapeutic use; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D001037:Aphasia; D001921:Brain / Q000473:pathology; D004569:Electroencephalography; D020803:Encephalitis, Herpes Simplex / Q000134:cerebrospinal fluid / Q000473:pathology / Q000821:virology; D018259:Herpesvirus 1, Human; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D016133:Polymerase Chain Reaction; D012008:Recurrence; D065908:Transcranial Direct Current Stimulation / Q000009:adverse effects*
chemical_list: D000998:Antiviral Agents; D000212:Acyclovir
keywords: Aphasia; Encephalitis; Herpes simplex; Herpes simplex virus; Recurrence; Rehabilitation; Transcranial direct current stimulation