眼振所見を追いえた単純ヘルペス脳炎例

抄録

A five-year-old boy received treatment for ALL (acute lymphoblastic leukemia) for six months in the Pediatric Department of Hokkaido University Hospital.
Following mild upper respiratory infection, aphtous stomatitis and dizziness, horizontal nystagmus was noted in the primary eye position and he was sent to the ENT clinic for neurootological examination.
The findings of nystagmus varied from day to day and it was suggested that the brainstem and cerebellar vermis were damaged, but CT scan and magnetic resonance imaging (MRI) did not reveal any significant lesion. The symptoms were considered most likely due to herpetic encephalitis, therefore, a ten-day course of acyclovir 180 mg/day was initiated.
Shortly after administration was begun, herpes simplex virus genomes were detected in the patient's cerebrospinal fluid (CSF) by polymerase chain reaction (PCR). This case, therefore, was finally diagnosed as herpes simplex encephalitis.
Three months later, neurological examination showed that the child had almost returned to normal, and he was discharged.