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Anterior Temporal Lobectomy for Refractory Status Epilepticus in Herpes Simplex Encephalitis

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Abstract

Background

Herpes simplex virus (HSV) is a common cause of viral encephalitis that can lead to refractory seizures. The primary treatment of HSV encephalitis is with acyclovir; however, surgery sometimes plays a role in obtaining tissue diagnosis or decompression in cases with severe mass effect. We report a unique case in which anterior temporal lobectomy was successfully used to treat refractory status epilepticus in HSV encephalitis.

Methods

Case report and review of the literature.

Results

We report a case of a 60-year-old man with HSV encephalitis, who presented with seizures originating from the right temporal lobe refractory to maximal medical management. Right anterior temporal lobectomy was performed for the purpose of treatment of refractory status epilepticus and obtaining tissue diagnosis, with ultimate resolution of seizures and excellent functional outcome.

Conclusions

We suggest that anterior temporal lobectomy should be considered in cases of HSV encephalitis with refractory status epilepticus with clear unilateral origin.

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Authors and Affiliations

  1. Department of Neurosurgery, Massachusetts General Hospital, Wang 021, 55 Fruit Street, Boston, MA, 02114, USA

    Sarah K. B. Bick & Emad N. Eskandar

  2. Department of Neurology, Massachusetts General Hospital, Boston, MA, USA

    Saef Izzy, Daniel B. Rubin, Sahar F. Zafar & Eric S. Rosenthal

Authors
  1. Sarah K. B. Bick
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  2. Saef Izzy
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  3. Daniel B. Rubin
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  4. Sahar F. Zafar
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  5. Eric S. Rosenthal
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  6. Emad N. Eskandar
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Corresponding author

Correspondence to Sarah K. B. Bick.

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Conflict of interest

Dr. Rosenthal receives research support from an institutional contract with SAGE Therapeutics and grant funding from the Andrew David Heitman Neuroendovascular Research Foundation, NIBIB (5U54EB007954-04), NINDS (5U10NS080369-02), and the US Army Medical Research and Materiel Command (W81XWH-08-2-0154). Dr. Eskandar receives grant funding from the US Army Research Office and Defense Advanced Research Projects Agency (W911NF-14-2-0045) and has received research funding from and served on advisory panels for Medtronic and Cyberonics. All other authors report no conflicts of interest.

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Bick, S.K.B., Izzy, S., Rubin, D.B. et al. Anterior Temporal Lobectomy for Refractory Status Epilepticus in Herpes Simplex Encephalitis. Neurocrit Care 25, 458–463 (2016). https://doi.org/10.1007/s12028-016-0302-6

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  • DOI: https://doi.org/10.1007/s12028-016-0302-6

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