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MULTIPLE REFRACTORY SEIZURES IN PATIENT ENCEPHALITIS: CASE REPORT

AtityaFithriKhairani

BACKGROUND and aims: Herpes simplex encephalitis (HSE) is a rare neurological disorder characterized by inflammation of the brain. Common symptoms include headaches, fevers, drowsiness, hyperactivity, and seizure. Treatment of seizures is similar to that in patients with other focal epilepsies. However, epilepsy following HSV encephalitis is typically refractory to AEDs, often requiring combination treatment.This case report aims to report case multiple refractory seizure in patient encephalitis at dr. Sardjito Hospital Yogyakarta.   CASE:A woman 29 year-old patient was admitted to the Emergency Room Sardjito Hospital in February 2019 with complaints focal to bilateral tonicclonic seizure and epileptic status. The complaints begin with acute progressive headache, fever, visual hallucinations, and weakness of the left limbs. On examination, Glasgow Coma Scale (GCS) was E₂V_TM₂ (on midazolam)  and there were no signs of meningeal irritation. In the extremity, there is left lateralization. Laboratory tests and cerebrospinal fluid examinations were consistent with Herpes Simplex Virus encephalitis. CT scan patient showedoedemcerebri. After aggressive treatment with anti oedema, antiviral and antiepileptic drug, patient regaining full consciousness, seizures are reduced in frequency but still appear in focal aware seizures.

CONCLUSION:Herpes Simplex encephalitis can presented with refractory seizures with status epilepticus and need aggressive treatment.