This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
Herpes simplex encephalitis (HSE) may develop after high-dose corticosteroids, but has not been described after myxedema coma. We report a patient with myxedema coma who, after initial improvement, developed HSE likely due to activation of dormant herpes simplex virus (HSV) from a combination of myxedema, corticosteroid treatment, and acute illness. MRI of HSE and myxedema showed diffuse diffusion-weighted imaging abnormalities.
Case report.
Neighbors found an 81-year-old man unresponsive in his unheated home. His respiratory rate was irregular at 32, and his pulse was 10 to 20. Paramedics intubated him in the field. His admission temperature was 23 °C; he was slowly warmed and hydrated. Third-degree heart block necessitated transcutaneous pacing. His paced blood pressure was 90 mm Hg systolic. He had nonpitting edema around his orbits and extremities, yellow-tinged sclerae, difficult to auscultate cardiac tones, and course lung sounds. Pressure ulcerations marked his skin. He did not respond to command or question, his eyes remained closed, and he failed to localize pain. He had reactive pupils, poor extraocular movements, minimal …
AAN Members
We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.
AAN Non-Member Subscribers
Purchase access
Letters: Rapid online correspondence
REQUIREMENTS
You must ensure that your Disclosures have been updated within the previous six months. Please go to our Submission Site to add or update your Disclosure information.
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.
You May Also be Interested in
Alert Me
Recommended articles
Atypical manifestations and poor outcome of herpes simplex encephalitis in the immunocompromised
Early pathologic findings and long-term improvement in anti-Ma2–associated encephalitis
NMDA receptor antibodies associated with distinct white matter syndromes
Fatal Necrotizing Encephalitis Associated With COVID-19