Choreoathetosis after Herpes simplex encephalitis

After Herpes simplex encephalitis, 25% of cases may have a relapse, rarely as a choreoathetosic movement disorder. The anatomic basis for herpes simplex virus encephalitis-associated movement disorders remains poorly understood, but the hypothesis is that it may be due to a post-infectious immune-me...

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Bibliographic Details
Published in:Anales de pediatría (Barcelona, Spain : 2003) Spain : 2003), 2009-08, Vol.71 (2), p.153-156
Main Authors: Fernández Cooke, E, Simón de Las Heras, R, Muñoz González, A, Allende Martinez, L, Camacho Salas, A
Format: Article
Language:Spanish
Subjects:
Athetosis - etiology
Chorea - etiology
Encephalitis, Herpes Simplex - complications
Humans
Infant
Male
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Summary:After Herpes simplex encephalitis, 25% of cases may have a relapse, rarely as a choreoathetosic movement disorder. The anatomic basis for herpes simplex virus encephalitis-associated movement disorders remains poorly understood, but the hypothesis is that it may be due to a post-infectious immune-mediated process. We report an 8-month-old boy, with herpes simplex encephalitis type 1, who started with an extrapyramidal Syndrome, presenting with choreoathetosis and ballistic movements, three weeks after onset. These new symptoms were attributed to a post-infectious immune-mediated process. We treated our patient with corticosteroids at high dose and gamma-globulins, in addition to a new course of Acyclovir. Sedation was required to control the intense choreoathetosic movements. Tetrabenazine was also tried, unsuccessfully. We studied a mutation on the toll like receptors (TLR3), which has been related to susceptibility for the disease, which was negative.
ISSN:1695-4033
DOI:10.1016/j.anpedi.2009.04.020