PMC5548691_01
Brain magnetic resonance imaging showed high-intensity areas in the bilateral hippocampi (a and b, arrows) and periventricular white matter (c, arrow). Diffusion-weighted imaging (d) and apparent diffusion coefficient mapping (e) showed high-intensity signals (arrows), which were suggestive of vasogenic edema.
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Brain magnetic resonance imaging (MRI) showed high-intensity lesions in the bilateral hippocampi and periventricular white matter on fluid-attenuated inversion recovery images (Fig. 1a-c). Diffusion-weighted imaging and apparent diffusion coefficient mapping showed high-intensity signals emanating from the lesions, which were suggestive of vasogenic edema (Fig. 1d and e).
Clinical course of the case. The first vertical axis (left) and second axis (right) of the graph show the cell counts of the cerebrospinal fluid and body temperature, while the closed and open triangles indicate fits of seizures and myoclonus, respectively. ACV: acyclovir, BT: body temperature, CLB: clobazam, CSF: cerebrospinal fluid, CTRX: ceftriaxone, CZP: clonazepam, DZP: diazepam, F-FLCZ: fosfluconazole, HHV-7: human herpesvirus-7, IVIG: intravenous immunoglobulin, MDZ: midazolam, mPSL: methylprednisolone, PB: phenobarbital, PHT: phenytoin, VPA: valproate
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All viral DNA assays were performed by a commercial laboratory (SRL, Tokyo, Japan) (Fig. 2). The patient's CSF cell counts normalized, and the HHV-7 DNA disappeared three months later (Fig. 2). Since he suffered several seizures after being discharged, phenytoin and clobazam were added serially (Fig. 2).