Herpes simplex encephalitis as a potential cause of anti-N-methyl-D- aspartate receptor antibody encephalitis: Report of 2 cases

Allen DeSena, Donna Graves, Worthy Warnack, Benjamin M. Greenberg

Research output: Contribution to journalArticle

53 Citations (Scopus)

Abstract

IMPORTANCE: Encephalitis mediated by anti-N-methyl-D-aspartate (NMDA) receptor antibodies and herpes simplex (HS) encephalitis are seemingly separate causes of encephalopathy in adults and children. Herpes simplex encephalitis is infectious, and anti-NMDA receptor antibody encephalitis is autoimmune in origin. Both can cause seizures and encephalopathy, although the latter can also cause psychiatric symptoms and movement disorders. Owing to the rarity of these 2 diseases, patients with co-occurrence are important because they alert clinicians to possible links between 2 seemingly separate processes. OBSERVATIONS: In a case series of 2 patients observed at our center, we describe an infant and an adult who had confirmed HS encephalitis and then developed confirmed anti-NMDA receptor antibody encephalitis. Polymerase chain reaction testing for HS virus was performed. Testing for NMDA receptor antibodies was performed by Associated Regional and University Pathologists Laboratory in Salt Lake City, Utah. CONCLUSIONS AND RELEVANCE: We conclude that atypical cases of HS or other viral encephalitides should be investigated for concomitance of an autoimmune encephalitis. We suspect that the pathophysiologic mechanisms by which HS virus infects neurons produce a higher likelihood of contracting anti-NMDA receptor antibody encephalitis.

Original languageEnglish (US)
Pages (from-to)344-346
Number of pages3
JournalJAMA Neurology
Volume71
Issue number3
DOIs
StatePublished - Mar 2014

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Anti-N-Methyl-D-Aspartate Receptor Encephalitis
Herpes Simplex Encephalitis
Antibodies
Brain Diseases
Simplexvirus
Viral Encephalitis
Herpes Simplex
Movement Disorders
N-Methyl-D-Aspartate Receptors
Psychiatry
Seizures
Causes
Neurons
Polymerase Chain Reaction
Testing
Virus

ASJC Scopus subject areas

  • Arts and Humanities (miscellaneous)
  • Clinical Neurology

Cite this

Herpes simplex encephalitis as a potential cause of anti-N-methyl-D- aspartate receptor antibody encephalitis : Report of 2 cases. / DeSena, Allen; Graves, Donna; Warnack, Worthy; Greenberg, Benjamin M.

In: JAMA Neurology, Vol. 71, No. 3, 03.2014, p. 344-346.

Research output: Contribution to journalArticle

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