Metin ÖZSOY, Ülkü SİYAH, Salih CESUR, Ayşe BÜYÜKDEMİRCİ, Cigdem ATAMAN HATİPOGLU, Hüseyin ESMER, Selin ŞENOL, Gülşah GELİŞİGÜZEL, Sami KINIKLI

Bir olgu nedeniyle herpes simpleks tip 1 ensefaliti ve anti-N metil-D-aspartat reseptör antikor ensefaliti birlikteliği

Anti-N-metil-D-aspartat (NDMA) reseptör ensefaliti akut veya subakut seyir gösterebilen, nöbet, psikiyatrik semptomlar ve hareket bozukluğu ile karakterize otoimmun bir ensefalit türüdür. Herpes simpleks ensefaliti seyrinde anti-NDMA reseptör antikorlarının üretiminin tetiklenebileceği ve anti-NMDA ensefalitinin klinik olarak ortaya çıkabileceği bildirilmiştir. HSV ensefalitli hastaların %25’inde anti-NDMA reseptör antikorlarının ortaya çıktığı ve bilinçsel performasdaki iyileşmede bozulma ile ilişkili.olduğu rapor edilmiştir. Bu yazıda 30 yaşında kadın hastada HSV-tip 1 ensefaliti ile birlikte saptanan anti NMDA reseptör ensefaliti olgusu sunularak literatür gözden geçirildi. Hastanın HSV ensefalitine yönelik tedavisi bittikten sonra anksiyete, ajitasyon, halüsünasyon ve öfori gibi psikiyatrik semptomlarının devam etmesi üzerine BOS’da bakılan anti-NMDA reseptör antikorlarının pozitif saptanması ile tanı konuldu. Nöroloji kliniğine devredilen hastaya intravenöz immunglobulin tedavisi başlandı.

Anahtar Kelimeler:

Herpes simpleks ensefaliti, anti- NMDA reseptör antikoru, herpetik ensefalit tanısı

The association of herpes simplex type 1 encephalitis and anti –N methyl D aspartate receptor antibody encephalitis in a case

Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis is a type of autoimmune encephalitis characterized by seizures, psychiatric symptoms, and movement disorder, which may present with an acute or subacute course. It has been reported that the production of anti-NDMA receptor antibodies can be triggered in the course of herpes simplex encephalitis and anti-NMDA receptor encephalitis may occur clinically. It has been reported that 25% of patients with HSV encephalitis have anti-NDMA receptor antibodies and are associated with impaired improvement in cognitive performance. In this article, we present a case of anti-NMDA receptor encephalitis associated with HSV-type 1 encephalitis in a 30-year-old woman and review the literature. After the patient's treatment for HSV encephalitis ended, her psychiatric symptoms such as anxiety, agitation, hallucinations and euphoria persisted and he was diagnosed with anti NMDA receptor antibodies detected in CSF. The patient was transferred to the neurology clinic and intravenous immunoglobulin treatment was started.

Keywords:

Herpes simplex encephalitis, anti- NMDA receptor antibody, herpetic encephalitis diagnosis,

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