Xia Jeffrey, Ahmed Rasha
UCLA Medical Center, Los Angeles, CA, USA.
IDCases. 2024 Jul 6;37:e02027. doi: 10.1016/j.idcr.2024.e02027. eCollection 2024.
HSV-1 encephalitis (HSE) is the most common cause of fatal sporadic encephalitis in the United States. HSE in adults is most commonly due to the reactivation of HSV in the central nervous system (CNS) which results in CNS necrosis leading to neurological compromise. The most common symptoms include altered mentation, fever, seizures, and focal neurological deficits. HSE most commonly involves damage to the temporal lobes however can rarely involve other CNS structures such as the brainstem and cerebellum. Immunocompromised status may increase the risk of atypical HSE. HSE involvement of the brainstem, particularly the pons, most commonly cause neuro-ocular and neuro-bulbar deficits. Rarely can HSV brainstem encephalitis cause quadriplegia or locked-in syndrome. We present a case of HSV-1 rhombencephalitis complicated by locked-in syndrome in a patient with CLL.
单纯疱疹病毒1型脑炎（HSE）是美国散发性致命性脑炎最常见的病因。成人HSE最常见的原因是中枢神经系统（CNS）中单纯疱疹病毒的重新激活，这会导致CNS坏死，进而导致神经功能损害。最常见的症状包括精神状态改变、发热、癫痫发作和局灶性神经功能缺损。HSE最常累及颞叶，但很少累及其他CNS结构，如脑干和小脑。免疫功能低下状态可能会增加非典型HSE的风险。HSE累及脑干，尤其是脑桥，最常导致神经眼和神经球部功能缺损。单纯疱疹病毒脑干脑炎很少会导致四肢瘫痪或闭锁综合征。我们报告1例慢性淋巴细胞白血病（CLL）患者发生单纯疱疹病毒1型菱形脑炎并伴有闭锁综合征的病例。
