uu.seUppsala University Publications
Change search
ReferencesLink to record
Permanent link

Direct link
Viral triggering of anti-NMDA receptor encephalitis in a child: An important cause for disease relapse
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Clinical Immunology.
Show others and affiliations
2014 (English)In: European journal of paediatric neurology, ISSN 1090-3798, E-ISSN 1532-2130, Vol. 18, no 4, 543-546 p.Article in journal (Refereed) Published
Abstract [en]

Herpes simplex encephalitis (HSE) in children is a potentially devastating condition which is occasionally complicated by a clinical relapse. An autoimmune component has long been suspected in these relapses and recent findings suggest that antibodies against N-methyl-D-aspartate receptors (NMDARs) may be part of this mechanism. We here report an 11 months old girl with acute HSE and with negative NMDAR antibody serology at presentation who after an initial response to antiviral treatment deteriorated with seizures, abnormal movements, focal neurologic deficits and psychiatric symptoms. We show that this relapse occurred as production of NMDAR antibodies developed and that clinical improvement followed immunotherapy with a concomitant decrease in NMDAR antibody titers in CSF. She also developed a characteristic 15-20 Hz activity over both hemispheres which has been previously described as an electroencephalographic presentation of anti-NMDAR encephalitis. We conclude that relapse or persisting symptoms in HSE in children may represent an immune-mediated mechanism rather than a viral reactivation and that NMDAR antibodies should be analyzed as this may be of importance for the choice of therapy. 

Place, publisher, year, edition, pages
2014. Vol. 18, no 4, 543-546 p.
Keyword [en]
Herpes simplex 1, Autoimmune, CNS, Pediatric, Infant, Extreme delta brush, EEG
National Category
URN: urn:nbn:se:uu:diva-229725DOI: 10.1016/j.ejpn.2014.03.011ISI: 000338825000017OAI: oai:DiVA.org:uu-229725DiVA: diva2:738454
Available from: 2014-08-18 Created: 2014-08-12 Last updated: 2014-08-18Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full text

Search in DiVA

By author/editor
Karlsson-Parra, Alex
By organisation
Clinical Immunology
In the same journal
European journal of paediatric neurology

Search outside of DiVA

GoogleGoogle Scholar

Altmetric score

Total: 199 hits
ReferencesLink to record
Permanent link

Direct link