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. 2015 Aug 27:4:76-8.
doi: 10.1016/j.ebcr.2014.08.007. eCollection 2015.

Reactivation of herpes simplex virus-1 following epilepsy surgery

Sérgio Monteiro de Almeida  1 , Ana Crippa  2 , Cristina Cruz  3 , Luciano de Paola  2 , Luciana Paula de Souza  2 , Lucia Noronha  4 , Luis Fernando Bleggi Torres  4 , Julio A S Koneski  5 , Luis Felipe Cavalli Pessa  6 , Meri Bordignon Nogueira  6 , Sonia Mara Raboni  6 , Carlos Eduardo Silvado  6 , Luine Rosele Vidal  6
Affiliations

Reactivation of herpes simplex virus-1 following epilepsy surgery

Sérgio Monteiro de Almeida et al. Epilepsy Behav Case Rep. .

Abstract

Purpose: The present study reports a case of encephalitis due to herpes simplex virus-1 (HSV-1), following surgical manipulation of the site of a primary infection.

Methods: Herpes simplex virus-1 infection was confirmed by CSF PCR and DNA sequencing.

Results: The patient was an 11-year-old girl who required temporal lobe surgery for epilepsy. She had meningoencephalitis due to HSV at the age of 20 months, and she was treated with acyclovir. Three years later, the patient developed uncontrolled seizures that became more frequent and changed in character at 11 years of age. On the 12th postoperative day, she developed fever and seizures, and she was diagnosed with HSV-1 by positive CSF PCR. She was treated with acyclovir (30 mg/kg/day for 21 days). In this report, we describe the patient and review the relevant literature.

Conclusion: The authors stress the potential risk of reactivation of HSV encephalitis after intracranial surgery. Herpes simplex virus encephalitis must be considered in neurosurgical patients who develop postoperative seizures and fever.

Keywords: Encephalitis; Epilepsy; Herpes simplex; Neurosurgery; Reactivation.

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Figures

Fig. 1
Fig. 1
The immunohistochemical reactions with monoclonal antibody anti-HSV- 1. A. Reactions in the surgical specimens were negative. B. Positive control: reaction of monoclonal antibody with HSV-positive Vero cell culture. The arrow indicates a positive reaction. Magnification: 400×.
Fig. 2
Fig. 2
MRI image, coronal, FLAIR (fluid acquisition inversion recovery) sequence. TR: 11,000 ms; TE: 140 ms; FOV: 220 mm2. Showing sequelae: area of hyperintense signal, with cavitations, volumetric loss, and disruption of brain parenchyma.
See this image and copyright information in PMC

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