Rinsho Shinkeigaku (Clinical Neurology)

Case Report

Human herpesvirus 6 encephalitis followed by acute disseminated encephalomyelitis in an immunocompetent adult

Junichi Horie, M.D.1), Keisuke Suzuki, M.D., Ph.D.1), Toshiki Nakamura, M.D., Ph.D.2), Madoka Okamura, M.D., Ph.D.1), Akio Iwasaki, M.D.1) and Koichi Hirata, M.D., Ph.D.1)

1)Department of Neurology, Dokkyo Medical University
2)Department of Neurology, Rehabilitation Amakusa Hospital

A 26-year-old, otherwise healthy man presented with visual abnormality followed by loss of consciousness and convulsion. The patient then developed headache and fever 14 days later. Brain MRI showed hyperintensities in the left cingulate cortex. The cerrebrospinal fluid examinations showed mononuclear pleocytosis and positive PCR results for human herpesvirus 6 (HHV-6). A diagnosis of HHV-6 encephalitis and symptomatic epilepsy was made. The patient's clinical symptoms improved promptly following acyclovir treatment. However, 3 months later the patient noticed dysesthesia in the trunk, the left upper limb and the right lower limb. Brain and spine MRI showed multiple brain white matter lesions, the middle cerebellar peduncle and cervical spinal lesions. The symptoms resolved following methylprednisolone pulse therapy only. We report an adult patient with HHV-6 encephalitis followed by acute disseminated encephalomyelitis whose initial presentation was epilepsy. HHV-6 encephalitis should be included in the differential diagnosis of encephalitis of unknown etiology in an immunocompetent adult.
Full Text of this Article in Japanese PDF (523K)

(CLINICA NEUROL, 57: 174|179, 2017)
key words: HHV-6 encephalitis, immunocompetent adult, acute disseminated encephalomyelitis, epilepsy

(Received: 22-Dec-16)