Postherpetic Anti-N-methyl-D-aspartate Receptor Encephalitis after Hemispherotomy in a Patient with Intractable Startle Epilepsy

ERKENT I., GÖÇMEN R., Tezer F. İ., Oguz K. K., KÜÇÜKŞAHİN N., Soylemezoglu F., ...More

NEUROPEDIATRICS, vol.49, no.1, pp.63-67, 2018 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 49 Issue: 1
  • Publication Date: 2018
  • Doi Number: 10.1055/s-0037-1606640
  • Journal Name: NEUROPEDIATRICS
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.63-67
  • Keywords: herpes simplex encephalitis, hemispherotomy, startle epilepsy, autoimmune, pseudoneoplasm, anti-NMDAR antibody, HERPES-SIMPLEX ENCEPHALITIS, OF-THE-LITERATURE
  • Hacettepe University Affiliated: Yes

Abstract

Herpes simplex encephalitis (HSE) has been increasingly reported after neurosurgical procedures, mostly after tumor resections in patients with a prior history of HSE. Early detection and appropriate treatment are essential to prevent high mortality of the disease; however, there are diagnostic difficulties due to nonspecific prodromal symptoms. In addition, anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis has been reported after HSE as an immunological relapse. Here, we report a case of postherpetic anti-NMDAR encephalitis following right hemispherotomy for intractable startle-induced seizures, to emphasize the importance of early diagnosis and appropriate treatment. To our knowledge, this is the first reported case of anti-NMDAR encephalitis after postoperative HSE, and the third reported case of hemispherotomy as a curative treatment for startle epilepsy.