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

Abstract

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.

Keywords

• Herpes simplex virus encephalitis (HSVE)
• Anti-NMDA receptor autoimmune encephalitis anti-NMDAR encephalitis
• Brain tumor
• PCR array