Continuous video electroencephalogram for herpes simplex encephalitis:a case report and literature review

作     者：Wanhui Lin Shenggen Chen Hanbin Lin Changyun Liu Huapin Huang 

作者机构：Intensive Care UnitDepartment of NeurologyFujian Medical University Union HospitalFuzhou 350001China. Department of NeurologyFujian Medical University Union HospitalFuzhou 350001China. Department of GeriatricsFujian Medical University Union HospitalFujian Key Laboratory of Molecular NeurologyFuzhou 350001China. 

出 版 物：《Acta Epileptologica》 (癫痫学报（英文）)

年 卷 期：2020年第2卷第1期

页      面：75-82页

学科分类：1002[医学-临床医学] 10[医学] 

基　　金：the General Project of National Natural ScienceFoundation of China(Grant No.81901311) 

主　　题：Herpes simplex virus encephalitis Video electroencephalogram Non-convulsive status epilepticus Periodic lateralized epileptiform discharge Complications 

摘      要：Background:Electroencephalogram(EEG)is an important tool for the diagnosis of herpes simplex virus encephalitis(HSE).However,the diagnosis of non-convulsive status epilepticus(NCSE)in HSE is challenging without the help of continuous video EEG(CVEEG),and whether EEG is a predictor of outcome remains *** presentation:A 63-year-old woman presented with a 5 day history of fever,coma and *** of EEG,magnetic resonance imaging and polymerase chain reaction(PCR)in cerebrospinal fluid(CSF)were suggestive of herpes simplex encephalitis-1(HSE-1).Preliminary EEG showed periodic discharges at the prefrontal and temporal lobes,which were particularly synchronized with intermittent lip smacking movements,and the discharges were terminated by *** 2-week treatment with acyclovir,high-dose hormone pulse therapy and high-dose immunoglobulin therapy,the CSF was improved,but the patient’s consciousness became worsen,consistent with the diffuse slow waves in the delta range and low voltage of EEG *** the following 1 month,the patient had non-responsiveness to pain and sound as shown by CVEEG with diffuse slow *** paroxysmal very slow waves(0.5–1 Hz)were synchronized with intermittent paroxysmal eye movements,pupil abnormality,and sweating in the frontal *** 2 months of treatment,the EEG abnormalities improved to have alpha ***:The CVEEG not only helps identify NCSE but can also be used to monitor HSE progression.