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Neuropediatrics 2018; 49(01): 063-067
DOI: 10.1055/s-0037-1606640
Short Communication
Georg Thieme Verlag KG Stuttgart · New York

Postherpetic Anti-N-methyl-D-aspartate Receptor Encephalitis after Hemispherotomy in a Patient with Intractable Startle Epilepsy

Irem Erkent
1   Department of Neurology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
,
Rahsan Gocmen
2   Department of Radiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
,
F. Irsel Tezer
1   Department of Neurology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
,
Kader K. Oguz
2   Department of Radiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
,
Nalan Kucuksahin
1   Department of Neurology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
,
Figen Soylemezoglu
3   Department of Pathology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
,
Burcak Bilginer
4   Department of Neurosurgery, Faculty of Medicine, Hacettepe University, Ankara, Turkey
,
Serap Saygi
1   Department of Neurology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
› Author Affiliations
Further Information

Publication History

03 May 2017

08 August 2017

Publication Date:
22 September 2017 (online)

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Abstract

Herpes simplex encephalitis (HSE) has been increasingly reported after neurosurgical procedures, mostly after tumor resections in patients with a prior history of HSE. Early detection and appropriate treatment are essential to prevent high mortality of the disease; however, there are diagnostic difficulties due to nonspecific prodromal symptoms. In addition, anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis has been reported after HSE as an immunological relapse. Here, we report a case of postherpetic anti-NMDAR encephalitis following right hemispherotomy for intractable startle-induced seizures, to emphasize the importance of early diagnosis and appropriate treatment. To our knowledge, this is the first reported case of anti-NMDAR encephalitis after postoperative HSE, and the third reported case of hemispherotomy as a curative treatment for startle epilepsy.

Keywords

herpes simplex encephalitis - hemispherotomy - startle epilepsy - autoimmune - pseudoneoplasm - anti-NMDAR antibody
 

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