Abstract
A 13-year-old boy was admitted because of fever, headache, convulsions and disturbed consciousness for 7 days. Neurological examinations on admission revealed disturbance of consciousness, signs of meningeal irritation and left hemiplegia.
CT scan showed a low density area in the right medial temporal lobe with irregular enhancement by contrast medium and accompanying mass effects. Encephalitis was suspected. Antibiotics and γ-globulin were administered and external decompression was performed on the same day, because of progressive decrease in consciousness. Four days later, a marked low density area in the right cerebral hemisphere and parafalcial low density were seen in CT scan and the level of consciousness fell with decerebrate posture. Ventricular drainage was performed. Complement fixation titer of herpes simplex in the serum was×1, 024. β-interferon therapy was started and continued for 11 days by means of both intravenous and intrathecal administration (3×106 I.U. daily intravenously, 1×106 I.U. for 1 day and 3×106 I.U. for 3 days intrathecaly). Neurological and general condition of the patient improved gradually. There were no side effects of interferon except for fever. The follow-up CT scan showed a low density area in the right fronto-parietal region with cortical atrophy and ventricular dilatation. At follow-up 9 months later, the patient showed no hemiplegia nor memory disturbance and he could lead a daily life with some aid.
