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  • Case Study
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A case of maternal herpes simplex virus encephalitis during late pregnancy

Nature Clinical Practice Neurology volume 5, pages 51–56 (2009)Cite this article

Abstract

Background A pregnant 25-year-old woman at 32 weeks' gestation was admitted to an emergency unit after her husband had found her drowsy and with her tongue bitten. The day before admission, the patient had developed a fever of 39 °C, was suffering from headaches, was nauseated and had vomited. On admission, she had anterograde and retrograde amnesia, but no somatic neurological deficits were detected.

Investigations Routine laboratory testing, lumbar puncture, cerebrospinal fluid analysis, routine bacteriology, brain MRI, and polymerase chain reaction testing for neurotropic viruses including herpes simplex virus types 1 and 2.

Diagnosis Maternal herpes simplex virus type 1 encephalitis.

Management Antiviral and anticonvulsive therapy, supportive treatment, and cesarean section.

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Figure 1: Brain MRI scans of a patient with acute herpes simplex type 1 encephalitis.

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Acknowledgements

The authors appreciate the assistance of Dr A Tofield for his proofreading and editing of the English language in this manuscript. Written consent for publication was obtained from the patient. J Sellner and R Buonomano have contributed equally to this manuscript. Désirée Lie, University of California, Irvine, CA, is the author of and is solely responsible for the content of the learning objectives, questions and answers of the Medscape-accredited continuing medical education activity associated with this article.

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Authors and Affiliations

  1. J Sellner is a Resident and Fellow in the Department of Neurology, Klinikum rechts der Isar at the Technical University of Munich, Munich, Germany.,

    Johann Sellner

  2. R Buonomano is Attending Physician for Internal Medicine at the County Hospital of Aarau, Aarau,

    Roberto Buonomano

  3. K Nedeltchev is Consultant in the Department of Neurology at Triemli Municipal Hospital, Zurich,

    Krassen Nedeltchev

  4. O Findling is a Resident in the Department of Neurology, and DV Surbek is Acting Chairman of the Department of Obstetrics and Gynecology at Inselspital, G Schroth is Director of the Institute of Diagnostic and Interventional Neuroradiology, University of Bern, and SL Leib heads the Laboratory for Experimental Neuroinfectiology in the Institute for Infectious Diseases at the University of Bern and is Attending Physician for Infectious Diseases at Inselspital, University of Bern, Bern, Switzerland.,

    Oliver Findling, Gerhard Schroth, Daniel V Surbek & Stephen L Leib

Authors
  1. Johann Sellner
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  2. Roberto Buonomano
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  3. Krassen Nedeltchev
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  5. Gerhard Schroth
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  6. Daniel V Surbek
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  7. Stephen L Leib
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Corresponding author

Correspondence to Stephen L Leib.

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The authors declare no competing financial interests.

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Sellner, J., Buonomano, R., Nedeltchev, K. et al. A case of maternal herpes simplex virus encephalitis during late pregnancy. Nat Rev Neurol 5, 51–56 (2009). https://doi.org/10.1038/ncpneuro0972

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