Barthez-Carpentier M A, Rozenberg F, Dussaix E, Lebon P, Goudeau A, Billard C, Tardieu M
Unité de Neurochirurgie-Neurologie, Centre de Pédiatrie Gatien de Clocheville, Tours, France.
J Child Neurol. 1995 Sep;10(5):363-8. doi: 10.1177/088307389501000504.
We report five children who had recurrent central nervous system signs after conventional acyclovir therapy for herpes simplex encephalitis. Secondary exacerbation was characterized clinically by severe ballismic movement disorder in all five children, associated with fever, impairment of consciousness, and seizures. Biologic analysis in all children and magnetic resonance imaging and neuropathology studies of the brain in three cases were compatible with inflammatory reaction. In contrast, all viral cultures remained negative, herpes simplex virus antigen in one child and DNA tested by polymerase chain reaction in four children were undetectable in the first samples of cerebrospinal fluid during the relapse, suggesting a postinfectious, immune-mediated mechanism of relapse in these patients.
我们报告了5例在接受传统阿昔洛韦治疗单纯疱疹性脑炎后出现复发性中枢神经系统症状的儿童。继发加重在临床上表现为所有5例儿童均出现严重的舞蹈症样运动障碍，并伴有发热、意识障碍和癫痫发作。所有儿童的生物学分析以及3例儿童的脑部磁共振成像和神经病理学研究均与炎症反应相符。相比之下，所有病毒培养结果均为阴性，1例儿童的单纯疱疹病毒抗原以及4例儿童在复发时脑脊液首次样本中通过聚合酶链反应检测的DNA均未检测到，提示这些患者复发存在感染后免疫介导机制。
