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Radicals, the highly reactive species, gain stability by undergoing three different reactions. The first reaction involves a radical-radical coupling, in which a radical combines with another radical, forming a spin‐paired molecule. The second reaction is between a radical and a spin‐paired molecule, generating a new radical and a new spin‐paired molecule. The third reaction is radical decomposition in a unimolecular reaction, forming a new radical and a spin‐paired...
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HSV-Encephalitis Reactivation after Cervical Spine Surgery.

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Area of Science:

  • Neurology
  • Infectious Diseases
  • Neurosurgery

Background:

  • Herpes simplex virus encephalitis (HSVE) is a serious brain inflammation caused by HSV.
  • HSVE reactivation post-neurosurgery can lead to severe neurological deterioration.
  • Prompt diagnosis and management are vital due to high morbidity in untreated HSVE.

Observation:

  • A 78-year-old woman experienced declining mental status 11 days after cervical spinal surgery.
  • HSV-1 encephalitis reactivation was suspected, despite negative brain MRI scans.
  • The patient showed positive response to acyclovir treatment, improving to baseline neurological status.

Findings:

  • This case represents the first reported instance of HSVE reactivation following intradural cervical spinal surgery.
  • Negative MRI findings did not rule out HSVE reactivation in this patient.
  • Acyclovir treatment led to successful patient recovery.

Implications:

  • Consider HSVE reactivation in postoperative neurosurgery patients with altered mental status, even with negative MRI.
  • Utilize a combination of diagnostic tests (PCR, EEG, MRI) for accurate HSVE diagnosis.
  • Be aware of potential false-negative results from diagnostic tests and continue treatment if HSVE is suspected.