M. Bourgeois et al., Reactivation of herpes virus after surgery for epilepsy in a pediatric patient with mesial temporal sclerosis: Case report, NEUROSURGER, 44(3), 1999, pp. 633-635
OBJECTIVE: This case report is presented to raise the awareness of the pote
ntial risk of reactivation of herpes simplex virus (HSV) encephalitis after
intracranial surgery.
CLINICAL PRESENTATION: The case of an 8-year-old male patient who suffered
a reactivation of HSV encephalitis after undergoing amygdalohippocampectomy
for complex partial seizures is reported. This patient had previously cont
racted HSV 1 meningoencephalitis at the age of 16 months. Six years later,
a left amygdalohippocampectomy was proposed after the development of intrac
table partial epilepsy associated with left mesial temporal lesions. During
the postoperative period, the patient suffered severe clinical deteriorati
on with partial status epilepticus, aphasia, and hyperthermia, which resolv
ed after intensive antiepileptic treatment supported by acyclovir.
CONCLUSION: We advise prophylactic pre-, peri-, and postoperative treatment
with acyclovir for patients with known histories of HSV encephalitis who u
ndergo intracranial procedures.