Abstract
We report a 12-year-old boy with chronic stage of acute encephalitis with refractory, repetitive partial seizures (AERRPS). At the age of 1 year and 8 months, he was admitted to our hospital because of fever and repetitive convulsions. His consciousness was disturbed (Japan coma scaleII-20). After admission, generalized clonic convulsions and left or right hemiconvulsions with vomiting and apnea frequently occurred. Continuous midazolam infusion and intermittent intravenous pentobarbital injection were done. On cerebrospinal fluid (CSF) examination, cell count was 22/3. His whole blood cell counts and laboratory tests were normal. EEG showed diffuse high voltage slow waves. CT and MR images of his brain showed no abnormality. Therefore, we diagnosed him as having AERRPS. In the course of his disesase, NT antibody to HHV7 elevated, and viral DNA of HHV7 was detected in his plasma. HHV7 infection seemed to be related to the onset of his AERRPS. Convulsions occurred 6-12 times per month during the chronic phase of AERRPS although the intractable convulsions had been treated with CBZ, PHT, VPA, KBr, and DZP. After administering TPM, 300mg/day (6mg/kg/day), convulsions almost completely disappeared. Our report suggests that TPM might be effective for convulsions even in the chronic phase of AERRPS.
