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Chorea as a presentation of herpes simplex encephalitis relapse
G G Gascon1, A A al-Jarallah, E Okamoto
1Department of Pediatrics, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia.
Brain & Development
|May 1, 1993
Summary
Herpes simplex encephalitis (HSE) relapses can manifest as chorea in infants. Extended acyclovir treatment (3 weeks) may improve outcomes, while shorter courses show limited efficacy for this rare neurological complication.
Area of Science:
- Neurology
- Infectious Diseases
- Pediatrics
Background:
- Herpes simplex encephalitis (HSE) is a severe neurological infection.
- Relapses of HSE can present with varied neurological symptoms.
- Chorea as an initial manifestation of HSE relapse is rare in infants.
Observation:
- Three infants presented with chorea as the initial symptom of HSE relapse.
- Treatment responses to acyclovir varied significantly among patients.
- One patient relapsed years after initial treatment, while another showed no improvement.
Findings:
- Patient 3 showed clear improvement after a 3-week course of acyclovir.
- Patients treated with shorter or repeated 10-day courses had less favorable outcomes.
- A fourth patient with chorea, initially suspected as HSE, tested negative for HSV.
Implications:
- A minimum 3-week course of acyclovir at 30-35 mg/kg/day is recommended for HSE relapse presenting with chorea.
- This extended treatment duration may be crucial for managing this specific HSE complication.
- Accurate diagnosis is essential, as chorea can have other etiologies.