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Relapse of Herpes Simplex Encephalitis

Unité de Neurochirurgie-Neurologie, Centre de Pédiatrie Gatien de Clocheville, Tours

Flore Rozenberg, MD

Laboratoires de Virologie, Hôpital Saint Vincent de Paul, Paris

Elisabeth Dussaix, MD

Hôpital Bicêtre Le Kremlin Bicêtre

Pierre Lebon, MD

Laboratoires de Virologie, Hôpital Saint Vincent de Paul, Paris

Alain Goudeau, MD

Hôpital Bretonneau,Tours

Catherine Billard, MD

Unité de Neurochirurgie-Neurologie, Centre de Pédiatrie Gatien de Clocheville, Tours

Marc Tardieu, MD

Service de Neurologie, Département de Pédiatrie, Hôpital Bicêtre, Le Kremlin Bicêtre, France

We report five children who had recurrent central nervous system signs after conventional acyclovir therapy for herpes simplex encephalitis. Secondary exacerbation was characterized clinically by severe ballismic movement disorder in all five children, associated with fever, impairment of consciousness, and seizures. Biologic analysis in all children and magnetic resonance imaging and neuropathology studies of the brain in three cases were compatible with inflammatory reaction. In contrast, all viral cultures remained negative, herpes simplex virus antigen in one child and DNA tested by polymerase chain reaction in four children were undetectable in the first samples of cerebrospinal fluid during the relapse, suggesting a postinfectious, immune-mediated mechanism of relapse in these patients. (J Child Neurol 1995;10:363-367).

Journal of Child Neurology, Vol. 10, No. 5, 363-367 (1995)
DOI: 10.1177/088307389501000504


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