Chorea and Developmental Regression Associated With Human Herpes Virus-6 Encephalitis

Abstract We report a 14-month old child with multiple episodes of febrile status epilepticus, followed by chorea and developmental regression, caused by human herpes virus–6 encephalitis. Chorea has been described as a complication of relapsing herpes simplex virus I infection, but not as a manifest...

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Bibliographic Details
Published in:Pediatric neurology 2013-03, Vol.48 (3), p.249-251
Main Authors: Pulickal, Anoop S., MD, PhD, Ramachandran, Simi, MD, Rizek, Philippe, MD, Narula, Pramod, MD, Schubert, Romaine, MD
Format: Article
Language:English
Subjects:
Central nervous system
Children
Chorea
Chorea - virology
Encephalitis
Encephalitis, Viral - etiology
Epilepsy
Etiracetam
Female
foscarnet
Herpes simplex
Herpes simplex virus
Herpesvirus 6, Human - isolation & purification
Humans
Immunoglobulins
Infant
Infection
Intravenous administration
Language
Neurology
Pediatrics
Prognosis
Roseolovirus Infections - complications
Seizures
Seizures - virology
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Summary:Abstract We report a 14-month old child with multiple episodes of febrile status epilepticus, followed by chorea and developmental regression, caused by human herpes virus–6 encephalitis. Chorea has been described as a complication of relapsing herpes simplex virus I infection, but not as a manifestation of human herpes virus–6 infection. It is uncertain whether the chorea was an autoimmune phenomenon or a direct effect of the virus. The child was treated with levetiracetam, intravenous immunoglobulin, and foscarnet. The seizures and chorea resolved with treatment, but developmental regression, with loss of language skills, persisted 6 months after the illness. This child illustrates a new clinical presentation of human herpes virus–6 encephalitis, adds to the spectrum of disorders caused by this virus, and strengthens the case for routine identification of specific viral agents in all cases of childhood viral infections with central nervous system symptoms to determine optimal treatment and prognosis.
ISSN:0887-8994
1873-5150
DOI:10.1016/j.pediatrneurol.2012.11.010