TY - JOUR
T1 - A case of herpes simplex encephalitis with hypersomnia and low orexin level in the cerebrospinal fluid
AU - Mukaino, Akihiro
AU - Kinoshita, Ikuo
AU - Fukushima, Naomi
AU - Otsubo, Mayumi
AU - Kanbayashi, Takashi
PY - 2014/3
Y1 - 2014/3
N2 - A 60-year-old woman suffered from high fever (38°C) and abnormal behavior, was admitted to our hospital on the seventh day of the fever. At admission, she was stuporous, and a cerebrospinal fluid (CSF) analysis revealed pleocytosis (55/μl, monocytes). Fluid-attenuated inversion recovery (FLAIR) magnetic resonance (MR) images showed high-intensity signals in the medial temporal lobe, inferior surface of the frontal cortex, right cerebellar vermis, and left thalamus. We diagnosed herpes simplex encephalitis, based on the finding of an elevated titer of herpes simplex virus antibody in the CSF (2.90). She was started on treatment with acyclovir and steroid pulse therapy, which was followed by rapid clinical improvement. After recovering from the stupor, the patient exhibited the symptoms of hypersomnia with low orexin level in the CSF. Thus, we should bear in mind that other than consciousness disturbance, patients with herpes simplex encephalitis can also present with rare complications due to the extent of the lesions.
AB - A 60-year-old woman suffered from high fever (38°C) and abnormal behavior, was admitted to our hospital on the seventh day of the fever. At admission, she was stuporous, and a cerebrospinal fluid (CSF) analysis revealed pleocytosis (55/μl, monocytes). Fluid-attenuated inversion recovery (FLAIR) magnetic resonance (MR) images showed high-intensity signals in the medial temporal lobe, inferior surface of the frontal cortex, right cerebellar vermis, and left thalamus. We diagnosed herpes simplex encephalitis, based on the finding of an elevated titer of herpes simplex virus antibody in the CSF (2.90). She was started on treatment with acyclovir and steroid pulse therapy, which was followed by rapid clinical improvement. After recovering from the stupor, the patient exhibited the symptoms of hypersomnia with low orexin level in the CSF. Thus, we should bear in mind that other than consciousness disturbance, patients with herpes simplex encephalitis can also present with rare complications due to the extent of the lesions.
KW - Herpes simplex encephalitis
KW - Hypersomnia
KW - Orexin in the cerebrospinal fluid
UR - http://www.scopus.com/inward/record.url?scp=84896504413&partnerID=8YFLogxK
U2 - 10.5692/clinicalneurol.54.207
DO - 10.5692/clinicalneurol.54.207
M3 - 学術論文
C2 - 24705834
AN - SCOPUS:84896504413
SN - 0009-918X
VL - 54
SP - 207
EP - 211
JO - Clinical Neurology
JF - Clinical Neurology
IS - 3
ER -