1043-3155 Pediatr Neurol Briefs pedneurbriefs Pediatr Neurol Briefs Pediatric Neurology Briefs Pediatr Neurol Briefs 2166-6482 1043-3155 2166-3155 Pediatric Neurology Briefs Publishers Chicago, IL, USA PNB-1-35 10.15844/pedneurbriefs-1-5-7 Infectious Diseases Neurology Pediatrics Nervous System Diseases Child Development Brain Diseases Neurosurgery Child Infant Herpes Simplex Encephalitis http://orcid.org/0000-0002-0173-7931 Millichap J. Gordon MD 1 2 * Division of Neurology, Children's Memorial Hospital, Chicago, IL Departments of Pediatrics and Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL Correspondence: Dr. J. Gordon Millichap, E-mail: jgmillichap@northwestern.edu 10 1987 01 08 2016 1 5 35 36 Copyright: © 1987 The Author(s) 1987 This work is licensed under the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Herpes simplex encephalitis in third trimester of pregnancy: successful outcome for mother and child

The successful outcome of a case of herpes simplex encephalitis (HSE) in a pregnant woman at 29 weeks gestation is reported from the Depts of Neurology and Gynecology and Obstetrics, Royal Perth Hospital and the State Health Lab Services, Perth, Western Australia.

 Herpes Simplex Encephalitis Focal EEG Hypodense Area

The successful outcome of a case of herpes simplex encephalitis (HSE) in a pregnant woman at 29 weeks gestation is reported from the Depts of Neurology and Gynecology and Obstetrics, Royal Perth Hospital and the State Health Lab Services, Perth, Western Australia. The diagnosis was suspected from the clinical presentation with fever, headache, stupor, generalized convulsion, a focal EEG, and a hypodense area in the right temporal lobe on CT. It was confirmed retrospectively from evidence of specific antibody production in the CSF. Acyclovir 800 mg/d IV every 8 hours and in a reducing regime was continued for 22 days. She recovered after 2 months and delivered a normal unaffected baby. Mother has led a normal life except for right sided focal motor and grand mal seizures controlled with anticonvulsants for 3½ years and secondary to post-encephalitic temporal lobe atrophy. The child, aged 3½ years, is well. Infection with HSV in this patient was not disseminated and did not cross the placenta. Acyclovir was non-toxic to mother and fetus when used in the 3rd trimester of pregnancy. [1]

COMMENT: This case of HSE is the sixth to be reported in pregnancy and the second to survive. Only one previous fetus has survived a pregnancy complicated by HSE and the mother, treated with idoxuridine, died 5 days postpartum. Acyclovir reduces mortality of neonatal HSE and is well tolerated but morbidity in surviving infants is high especially if treatment is delayed. Early diagnosis is facilitated by MRI [2]. For a review of the natural history of HSV infection of mother and newborn and therapy of neonatal HSV infection, see Whitley RJ et al. and Infectious Disease Collaboration Antiviral Study Group. Pediatrics 1980:66:489-501.

 Hankey GJ Bucens MR Chambers JS Herpes simplex encephalitis in third trimester of pregnancy: successful outcome for mother and child Neurology 1987 Sep 37 9 1534 7 3627453 10.1212/WNL.37.9.1534 Schroth G Gawehn J Thron A Vallbracht A Voigt K Early diagnosis of herpes simplex encephalitis by MRI Neurology 1987 Feb 37 2 179 83 3808297 10.1212/WNL.37.2.179