{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,22]],"date-time":"2025-02-22T00:46:02Z","timestamp":1740185162650,"version":"3.37.3"},"reference-count":21,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,6,27]],"date-time":"2024-06-27T00:00:00Z","timestamp":1719446400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Annals of the Child Neurology Society"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Herpes simplex virus (HSV) encephalitis can be associated with many secondary neurological complications, but having multiple episodes of recurrent neurological complications is rare in an individual. Understanding the course of each complication can reduce time to diagnosis and adequate treatment. Additionally, we postulate the role of <jats:italic>RNF213<\/jats:italic> mutation in HSV susceptibility.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We describe a unique presentation of HSV\u20101 encephalitis in an infant with a pathogenic <jats:italic>RNF213<\/jats:italic> mutation who went on to develop multiple rare neurological complications over the course of her illness.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Our patient was first diagnosed with neonatal HSV\u20101 encephalitis at age 2 weeks. She had recurrence of HSV encephalitis (HSE) with associated vasculopathy that led to right middle cerebral artery\u00a0and posterior cerebral artery\u00a0infarctions\u00a0at 13 months, and then later developed post\u2010HSE anti\u2010<jats:italic>N<\/jats:italic>\u2010methyl\u2010\n<jats:sc>d<\/jats:sc>\u2010aspartate receptor\u00a0encephalitis. All of this occurred concomitant with\u00a0<jats:italic>RNF213<\/jats:italic> mutation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>This patient demonstrates that, though rare, multiple neurological complications can occur in a single person, thus highlighting the importance of close surveillance of patients with a history of neonatal HSE and pursuing a broad differential in patients with subtle or recurrent symptoms. Furthermore, we propose a potential role of <jats:italic>RNF213<\/jats:italic> mutation in the pathogenesis of our patient's multiple medical conditions.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cns3.20079","type":"journal-article","created":{"date-parts":[[2024,6,27]],"date-time":"2024-06-27T10:20:37Z","timestamp":1719483637000},"page":"235-241","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Recurrent encephalitis and stroke following cessation of acyclovir prophylaxis in a patient with neonatal herpes simplex virus with <i>RNF213<\/i> mutation"],"prefix":"10.1002","volume":"2","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7170-4879","authenticated-orcid":false,"given":"Rutu M.","family":"Dave","sequence":"first","affiliation":[{"name":"Department of Neurology University of California Irvine Orange California 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