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[Complicated febrile convulsion vs herpes-encephalitis]
1Universitäts-Kinderklinik Graz, Osterreich.
Insights
Herpes simplex virus (HSV) encephalitis can present as febrile seizures in children. Early diagnosis via cerebrospinal fluid (CSF) HSV polymerase chain reaction (PCR) is crucial for timely Acyclovir treatment.
Area of Science:
- Neurology
- Virology
- Pediatrics
Context:
- Febrile seizures are common in children.
- Herpes simplex virus (HSV) encephalitis is a serious neurological condition.
- Acyclovir is an effective treatment for HSV encephalitis.
Purpose:
- To investigate the occurrence of HSV encephalitis in children presenting with febrile convulsions.
- To highlight the diagnostic utility of CSF HSV PCR in suspected cases.
Summary:
- Five children with complicated febrile convulsions were diagnosed with HSV encephalitis.
- Standard serological tests for HSV antibodies in serum and CSF were negative.
- Diagnosis was confirmed by positive CSF HSV polymerase chain reaction (PCR).
Impact:
- Early identification of HSV encephalitis in children with febrile seizures is critical.
- CSF HSV PCR enables rapid diagnosis and initiation of Acyclovir therapy.
- This diagnostic approach can prevent severe neurological sequelae.
Abstract:
Since Acyclovir is available a sufficient treatment of herpes simplex virus (HSV) encephalitis exists. Febrile convulsions may occur as the initial manifestation of an encephalitis, particularly of an HSV encephalitis. Within 25 months out of 151 children with febrile convulsions five children with complicated febrile convulsions were admitted at the pediatric department of Graz. In all children HSV antibodies in serum and cerebrospinal fluid (CSF) were negative and the diagnosis of an HSV encephalitis was made by positive CSF HSV polymerase chain reaction (PCR). Therefore, in any suspected case, i.e. in any case of a complicated febrile convulsion, CSF should be investigated including a HSV PCR to rapidly confirm or exclude HSV encephalitis.