Anterior Temporal Lobectomy for Refractory Status Epilepticus in Herpes Simplex Encephalitis

Background Herpes simplex virus (HSV) is a common cause of viral encephalitis that can lead to refractory seizures. The primary treatment of HSV encephalitis is with acyclovir; however, surgery sometimes plays a role in obtaining tissue diagnosis or decompression in cases with severe mass effect. We...

Full description

Saved in:
Bibliographic Details
Published in:Neurocritical care 2016-12, Vol.25 (3), p.458-463
Main Authors: Bick, Sarah K. B., Izzy, Saef, Rubin, Daniel B., Zafar, Sahar F., Rosenthal, Eric S., Eskandar, Emad N.
Format: Article
Language:English
Subjects:
Anterior Temporal Lobectomy - methods
Case reports
Convulsions & seizures
Critical Care Medicine
Drug Resistant Epilepsy - etiology
Drug Resistant Epilepsy - surgery
Edema
Encephalitis
Encephalitis, Herpes Simplex - complications
Herpes viruses
Humans
Intensive
Internal Medicine
Male
Medical imaging
Medicine
Medicine & Public Health
Memory
Middle Aged
Mortality
Neurology
Patients
Practical Pearl
Status Epilepticus - etiology
Status Epilepticus - surgery
Thoracic surgery
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background Herpes simplex virus (HSV) is a common cause of viral encephalitis that can lead to refractory seizures. The primary treatment of HSV encephalitis is with acyclovir; however, surgery sometimes plays a role in obtaining tissue diagnosis or decompression in cases with severe mass effect. We report a unique case in which anterior temporal lobectomy was successfully used to treat refractory status epilepticus in HSV encephalitis. Methods Case report and review of the literature. Results We report a case of a 60-year-old man with HSV encephalitis, who presented with seizures originating from the right temporal lobe refractory to maximal medical management. Right anterior temporal lobectomy was performed for the purpose of treatment of refractory status epilepticus and obtaining tissue diagnosis, with ultimate resolution of seizures and excellent functional outcome. Conclusions We suggest that anterior temporal lobectomy should be considered in cases of HSV encephalitis with refractory status epilepticus with clear unilateral origin.
ISSN:1541-6933
1556-0961
DOI:10.1007/s12028-016-0302-6