Abstract
N-methyl-D-aspartate receptor antibodies (NMDAR-Abs) can contribute to neurological relapse after herpes simplex virus encephalitis (HSE). We describe a child with NMDAR-Ab encephalitis after HSE, which was recognized and treated early. We discuss the case in the context of existing reports, and we propose a modified immunotherapy strategy to minimize risk of viral reactivation.
Keywords:
HSV; NMDAR; encephalitis; pediatric; plasmapheresis.
MeSH terms
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Acyclovir / therapeutic use*
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Anti-N-Methyl-D-Aspartate Receptor Encephalitis / complications*
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Anti-N-Methyl-D-Aspartate Receptor Encephalitis / diagnostic imaging
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Anti-N-Methyl-D-Aspartate Receptor Encephalitis / rehabilitation
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Anti-N-Methyl-D-Aspartate Receptor Encephalitis / therapy*
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Antiviral Agents / therapeutic use
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Autoantibodies / immunology
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Clonidine / therapeutic use
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Diazepam / therapeutic use
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Encephalitis, Herpes Simplex / complications*
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Encephalitis, Herpes Simplex / diagnostic imaging
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Encephalitis, Herpes Simplex / rehabilitation
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Encephalitis, Herpes Simplex / therapy*
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Encephalomalacia / diagnostic imaging
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Encephalomalacia / etiology
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Female
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Fever / etiology
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Humans
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Immunocompromised Host / drug effects
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Immunocompromised Host / immunology
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Immunosuppression Therapy / methods*
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Infant
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Leukoencephalopathies / diagnostic imaging
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Leukoencephalopathies / etiology
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Movement Disorders / etiology
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Neurological Rehabilitation
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Pakistan
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Paresis / etiology
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Phenobarbital / therapeutic use
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Phenytoin / therapeutic use
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Plasmapheresis
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Receptors, N-Methyl-D-Aspartate / immunology*
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Seizures / etiology
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Trihexyphenidyl / therapeutic use
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United Kingdom
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Valproic Acid / therapeutic use
Substances
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Antiviral Agents
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Autoantibodies
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Receptors, N-Methyl-D-Aspartate
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Valproic Acid
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Phenytoin
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Trihexyphenidyl
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Clonidine
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Diazepam
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Acyclovir
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Phenobarbital