{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T01:41:40Z","timestamp":1784770900543,"version":"3.55.0"},"reference-count":10,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,4,28]]},"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:p>We present a 24-year-old man with a 2-year history of progressive right-sided monocular vision loss with no other symptoms. An MRI showed a meningioma compressing the right optic nerve and the cavernous sinus. The tumour was partially resected. Eight days after discharge the patient was admitted with fever, a severe stabbing headache, insomnia, nausea and vomiting. A FilmArray panel and a cerebral biopsy were performed which were positive for herpes simplex virus 1 (HSV-1). An MRI of the brain showed asymmetric bilateral lesions in the frontobasal region with predominance of the right side. Acyclovir was started and continued until completing 21 days. A month after discharge, he started experiencing insomnia, trichotillomania, limb tremor, persistence of abulia, apathy and emotional lability. An HSV-1 encephalitis relapse was suspected, acyclovir and foscarnet were started. Due to the poor response to antiviral therapy CSF was tested, which was positive for anti-NMDA receptor encephalitis. A treatment course of intravenous immunoglobulin was started with a favourable outcome.<\/jats:p>","DOI":"10.1136\/bcr-2020-241136","type":"journal-article","created":{"date-parts":[[2021,5,26]],"date-time":"2021-05-26T14:38:02Z","timestamp":1622039882000},"page":"e241136","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Acute HSV and anti-NMDA encephalitis occurring as a neurosurgical complication"],"prefix":"10.1136","volume":"14","author":[{"given":"Jaime","family":"Toro","sequence":"first","affiliation":[{"name":"Neurology, Fundacion Santa Fe de Bogota, Bogota, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Sebastian","family":"Rivera","sequence":"additional","affiliation":[{"name":"Neurology, Fundacion Santa Fe de Bogota, Bogota, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Habib","family":"Moutran-Barroso","sequence":"additional","affiliation":[{"name":"Neurology, Fundacion Santa Fe de Bogota, Bogota, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia","family":"Valencia-Enciso","sequence":"additional","affiliation":[{"name":"Universidad de los Andes, Bogota, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,5,26]]},"reference":[{"key":"2025082622405757000_14.5.e241136.1","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1056\/NEJMra1708714","article-title":"Acute viral encephalitis","volume":"379","author":"Tyler","year":"2018","journal-title":"N Engl J Med"},{"key":"2025082622405757000_14.5.e241136.2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(18)30244-8"},{"key":"2025082622405757000_14.5.e241136.3","doi-asserted-by":"crossref","first-page":"1736","DOI":"10.1212\/WNL.0000000000002125","article-title":"Autoimmune post-herpes simplex encephalitis of adults and teenagers","volume":"85","author":"Armangue","year":"2015","journal-title":"Neurology"},{"key":"2025082622405757000_14.5.e241136.4","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1080\/15622975.2018.1555376","article-title":"Autoimmune encephalitis with psychosis: warning signs, step-by-step diagnostics and treatment","volume":"21","author":"Steiner","year":"2020","journal-title":"The World Journal of Biological Psychiatry"},{"key":"2025082622405757000_14.5.e241136.5","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(12)70310-1"},{"key":"2025082622405757000_14.5.e241136.6","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1055\/s-0032-1309062","article-title":"Herpes simplex encephalitis after neurosurgical operations: report of 2 cases and review of the literature","volume":"73","author":"Kuhnt","year":"2012","journal-title":"J Neurol Surg A Cent Eur Neurosurg"},{"key":"2025082622405757000_14.5.e241136.7","doi-asserted-by":"crossref","DOI":"10.3171\/2019.5.FOCUS19281","article-title":"Herpes simplex reactivation following neurosurgery: case report and review of the literature","volume":"47","author":"McLaughlin","year":"2019","journal-title":"Neurosurg Focus"},{"key":"2025082622405757000_14.5.e241136.8","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.61.3.325"},{"key":"2025082622405757000_14.5.e241136.9","doi-asserted-by":"crossref","first-page":"1349","DOI":"10.1212\/CON.0000000000000661","article-title":"Herpesvirus infections of the nervous system","volume":"24","author":"Baldwin","year":"2018","journal-title":"Continuum"},{"key":"2025082622405757000_14.5.e241136.10","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-444-53488-0.00011-0"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2020-241136","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T05:41:02Z","timestamp":1756273262000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2020-241136"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5]]},"references-count":10,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2021,5,26]]},"published-print":{"date-parts":[[2021,5]]}},"alternative-id":["10.1136\/bcr-2020-241136"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2020-241136","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5]]}}}