Seizure associated with acute hepatitis E

Abstract

logic symptoms revealed an elevated activated partial thromboplastin time (aPTT) of 92 seconds. Fifteen minutes after recanalization the ipsilateral MFV had normalized. At this time, CT showed right-sided hemorrhage in the basal ganglia (see the figure, D). Receiving intensive rehabilitation therapy, the patient became increasingly more mobilized with time; but 90 days later, he still depended on extensive help in his daily activities (Rankin score 4).In this case of hyperperfusion-induced ICH after PTA and stenting of the ICA, CBF velocity was continuously monitored by TCD before and at symptom onset. In the cases previously reported, postintervention hyperperfusion at symptom onset was assumed but not documented. 3-7 Such documentation, however, may be crucial for identifying patients at risk of ICH. The present case demonstrates that TCD can easily be performed during PTA and stenting.In summary, intracerebral hemorrhage is an increasingly recognized complication of PTA/stenting. Although its frequency has not yet been determined, it may exceed that of intracerebral hemorrhage after CEA. In the majority of cases, it is not preceded by reliable clinical symptoms, therefore peri-and postintervention monitoring is mandatory. Because TCD can be used to identify patients at risk, it may play an important role in the management of hyperperfusion in these patients, as well as help physicians to devise therapeutic strategies, such as careful control of even moderately elevated blood pressure, to avoid postintervention hemorrhage.

Hepatitis E Virus Infection

“…Neurological symptoms have been described for HEV1 and acute and chronic HEV3 infections (26). The neurological manifestations observed in HEV patients are Guillain-Barré syndrome (27-35), Bell's palsy (36), neuralgic amyotrophy (37,38), acute transverse myelitis (39), and acute meningoencephalitis (29,40). In a retrospective analysis of 126 patients with HEV infection, neurological symptoms were observed in 7 patients (5.5%), including 3 immunocompetent patients with acute HEV3 infection, 3 solid organ transplant (SOT) recipients, and 1 HIV-positive individual with chronic infection (21).…”

Host Immune Status and Response to Hepatitis E Virus Infection

“…Several case reports have noted neurological symptoms during or shortly after acute infection, such as meningitis (37), meningoencephalitis (38), acute transverse myelitis (39), Guillain-Barré syndrome (40)(41)(42)(43)(44)(45)(46), and other peripheral neuropathies (47,48). However, these presentations appear to be relatively infrequent.…”

Association of Bell's Palsy with Hepatitis E Virus Infection: A Rare Entity

“…The initial reports of neurologic disorder in HEV have come mainly from the India. [6][7][8][9][10][11][12] Notably, in all of these Figure 1 Right-sided lower motor neuron facial palsy.…”

“…1 Neurologic involvement in HEV is distinctly rare and approximately 24 cases have been described so far. 1,[6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] Reports of 22 cases are summarized in Table 1. 1,[6][7][8][9][10][11][13][14][15][16][17][18][19][20] Guillain-Barré syndrome, 1,6 (Table 1).…”