Hersh Nir, Ben Zvi Haim, Goldstein Lilach, Steiner Israel, Benninger Felix
Department of Neurology, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel; Neurology Unit, Sanz Medical Center, Laniado Hospital, Netanya, Israel.
Department of Neurology, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel; Sackler Faculty of Medicine, University of Tel Aviv, Tel Aviv, Israel.
Epilepsy Res. 2023 May;192:107137. doi: 10.1016/j.eplepsyres.2023.107137. Epub 2023 Apr 5.
Herpes simplex encephalitis (HSE) is associated with severe mortality and morbidity. Its incidence is estimated at 1:250 000, and the typical symptomatology of acute disease including headaches, mental state disturbances, confusion, sleepiness, and seizures. The chronic phase of the disease is occasionally characterized by epilepsy and neurological deficits.
The present retrospective single-center study aims to identify risk factors for predicting the development of epilepsy (epileptogenesis) following HSE.
Medical records were screened for patients older than 18 years, hospitalized between January 2005 and September 2019 with a diagnosis of "encephalitis" and "herpes simplex virus, HSV" infection. HSE diagnosis was based on an analysis of the cerebrospinal fluid with positive HSV testing results.
Twenty-three patients fit our inclusion criteria: fever and behavioral changes, followed by seizures, were reported in 58.3 % of patients. On follow-up (59.7 ± 38.8 months), eight patients (34.8 %) developed epilepsy. Pathological imaging and EEG were correlated with acute symptomatic seizures (ASS). ASS was associated with an 8-fold risk increase to develop post-encephalitis epilepsy (PE). PE was associated with younger age but not with CSF results, imaging, or EEG.
Our retrospective single-center study on PE, following HSE, shows that younger age and ASS were associated with PE. Brain imaging, CSF analysis, and EEG were not associated with the development of epilepsy following HSE.
单纯疱疹病毒性脑炎（HSE）与严重的死亡率和发病率相关。其发病率估计为1:250000，急性疾病的典型症状包括头痛、精神状态紊乱、意识模糊、嗜睡和癫痫发作。该疾病的慢性期偶尔以癫痫和神经功能缺损为特征。
本项回顾性单中心研究旨在确定预测HSE后癫痫发生（癫痫发生）的危险因素。
筛查2005年1月至2019年9月期间住院的18岁以上诊断为“脑炎”和“单纯疱疹病毒，HSV”感染的患者的病历。HSE诊断基于脑脊液分析且HSV检测结果呈阳性。
23例患者符合我们的纳入标准：58.3%的患者报告有发热和行为改变，随后出现癫痫发作。在随访（59.7±38.8个月）期间，8例患者（34.8%）发生了癫痫。病理影像学和脑电图与急性症状性癫痫发作（ASS）相关。ASS与发生脑炎后癫痫（PE）的风险增加8倍相关。PE与较年轻的年龄相关，但与脑脊液结果、影像学或脑电图无关。
我们对HSE后PE的回顾性单中心研究表明，较年轻的年龄和ASS与PE相关。脑影像学、脑脊液分析和脑电图与HSE后癫痫的发生无关。
