The first recorded case of herpes simplex virus encephalitis followed by anti-NMDA receptor autoimmune encephalitis after resection of meningioma

• Main Authors: Diego F. Gomez, Juan M. Gomez, Daniel Jaramillo-Velasquez, Fernando Hakim, Camila Pedraza, Elizabeth Reyes
• Format: Article
• Language: English
• Published: Elsevier 2021-06-01
• Series: Interdisciplinary Neurosurgery
• Subjects: Herpes simplex virus encephalitis (HSVE); Anti-NMDA receptor autoimmune encephalitis anti-NMDAR encephalitis; Brain tumor; PCR array
• Online Access: http://www.sciencedirect.com/science/article/pii/S2214751920306071
• ISSN: 2214-7519

Herpes simplex virus encephalitis (HSVE) is the most common cause of encephalitis with very high rates of mortality. Only 40 cases of postoperative HSVE have been reported; most authors agree it might be reactivation secondary to surgical stress and preoperative steroid immunosuppression. Concomitant HSVE and anti N-methyl-D-aspartate (NMDA) receptor, has already been reported. We report the first case of anti-NMDA receptor encephalitis after postoperative HSVE. Anti-NMDA receptor autoimmune encephalitis after postoperative HSVE is a cytokine-mediated encephalitis. Timely diagnosis and management of both conditions are of paramount importance for neurologic prognosis. Our case responded adequately after timely management with antiviral drug and immunotherapy.