癫痫手术后单纯疱疹病毒1型的再激活。
Reactivation of herpes simplex virus-1 following epilepsy surgery.
作者信息
de Almeida Sérgio Monteiro, Crippa Ana, Cruz Cristina, de Paola Luciano, de Souza Luciana Paula, Noronha Lucia, Torres Luis Fernando Bleggi, Koneski Julio A S, Pessa Luis Felipe Cavalli, Nogueira Meri Bordignon, Raboni Sonia Mara, Silvado Carlos Eduardo, Vidal Luine Rosele
机构信息
Laboratório de Virologia, 1-4 Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Paraná, Brazil ; Instituto de Pesquisa Pelé Pequeno Príncipe & Faculdades Pequeno Príncipe, Curitiba, Paraná, Brazil.
Serviço de Epilepsia, 1-4 Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Paraná, Brazil.
出版信息
Epilepsy Behav Case Rep. 2015 Aug 27;4:76-8. doi: 10.1016/j.ebcr.2014.08.007. eCollection 2015.
PURPOSE
The present study reports a case of encephalitis due to herpes simplex virus-1 (HSV-1), following surgical manipulation of the site of a primary infection.
METHODS
Herpes simplex virus-1 infection was confirmed by CSF PCR and DNA sequencing.
RESULTS
The patient was an 11-year-old girl who required temporal lobe surgery for epilepsy. She had meningoencephalitis due to HSV at the age of 20 months, and she was treated with acyclovir. Three years later, the patient developed uncontrolled seizures that became more frequent and changed in character at 11 years of age. On the 12th postoperative day, she developed fever and seizures, and she was diagnosed with HSV-1 by positive CSF PCR. She was treated with acyclovir (30 mg/kg/day for 21 days). In this report, we describe the patient and review the relevant literature.
CONCLUSION
The authors stress the potential risk of reactivation of HSV encephalitis after intracranial surgery. Herpes simplex virus encephalitis must be considered in neurosurgical patients who develop postoperative seizures and fever.
目的
本研究报告1例原发性感染部位经手术操作后发生的单纯疱疹病毒1型（HSV-1）脑炎病例。
方法
通过脑脊液聚合酶链反应（CSF PCR）和DNA测序确诊HSV-1感染。
结果
患者为一名11岁女孩，因癫痫需要进行颞叶手术。她在20个月大时患了由HSV引起的脑膜脑炎，接受了阿昔洛韦治疗。三年后，患者在11岁时出现无法控制的癫痫发作，发作频率增加且性质改变。术后第12天，她出现发热和癫痫发作，脑脊液PCR检测呈阳性，被诊断为HSV-1感染。她接受了阿昔洛韦治疗（30mg/kg/天，共21天）。在本报告中，我们描述了该患者并回顾了相关文献。
结论
作者强调颅内手术后HSV脑炎再激活的潜在风险。对于术后出现癫痫发作和发热的神经外科患者，必须考虑单纯疱疹病毒性脑炎。
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