title: [Post-herpes simplex encephalitis chorea: Viral replication or immunological mechanism?].
abstract: BACKGROUND
  Herpes simplex encephalitis is a severe neurological condition, whose outcome is improved if treated early with acyclovir. Post-herpes simplex encephalitis with acute chorea has rarely been reported.
  
  
  METHODS
  We report on two observations of children presenting with post-herpes simplex encephalitis with acute chorea, related to two different pathophysiological mechanisms. The first one is an 11-month-old girl developing relapsing herpes simplex encephalitis with chorea due to resumption of viral replication. The second one is a 2-year-old boy with relapsing post-herpes simplex encephalitis acute chorea caused by an immunoinflammatory mechanism. We discuss the different neurological presentations of herpetic relapses, notably those presenting with movement disorders, as well as their clinical, paraclinical, physiopathological, and therapeutic aspects.
  
  
  CONCLUSIONS
  Post-herpes simplex encephalitis with acute chorea may involve two mechanisms: resumption of viral replication or an immunoinflammatory mechanism. Treatment of post-herpes simplex encephalitis with acute chorea depends on the underlying mechanism, while prevention is based on antiviral treatment of herpes simplex encephalitis with acyclovir at the dose of 20mg/kg/8h for 21 days.
authors.affiliation: UR 06/11, service de neurologie de l'enfant et de l'adolescent, Institut national de neurologie Mongi Ben Hmida de Tunis, 1007 Tunis, Tunisie. Electronic address: hanenebenrhouma@yahoo.fr.
authors.forename: H
authors.initials: H
authors.lastname: Benrhouma
authors.affiliation: UR 06/11, service de neurologie de l'enfant et de l'adolescent, Institut national de neurologie Mongi Ben Hmida de Tunis, 1007 Tunis, Tunisie.
authors.forename: A
authors.initials: A
authors.lastname: Nasri
authors.affiliation: UR 06/11, service de neurologie de l'enfant et de l'adolescent, Institut national de neurologie Mongi Ben Hmida de Tunis, 1007 Tunis, Tunisie.
authors.forename: I
authors.initials: I
authors.lastname: Kraoua
authors.affiliation: UR 06/11, service de neurologie de l'enfant et de l'adolescent, Institut national de neurologie Mongi Ben Hmida de Tunis, 1007 Tunis, Tunisie.
authors.forename: H
authors.initials: H
authors.lastname: Klaa
authors.affiliation: UR 06/11, service de neurologie de l'enfant et de l'adolescent, Institut national de neurologie Mongi Ben Hmida de Tunis, 1007 Tunis, Tunisie.
authors.forename: I
authors.initials: I
authors.lastname: Turki
authors.affiliation: UR 06/11, service de neurologie de l'enfant et de l'adolescent, Institut national de neurologie Mongi Ben Hmida de Tunis, 1007 Tunis, Tunisie.
authors.forename: N
authors.initials: N
authors.lastname: Gouider-Khouja
mesh_terms: D000212:Acyclovir / Q000627:therapeutic use*; D000998:Antiviral Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D002819:Chorea / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology / Q000821:virology*; D003241:Consanguinity; D020803:Encephalitis, Herpes Simplex / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology; D005260:Female; D006801:Humans; D008297:Male; D012008:Recurrence; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D000212:Acyclovir