The role of viral encephalitis in the development of epileptic attacks and epilepsy
Keywords:viral encephalitis, HIV-infection, epileptic seizures, risk factors, treatment, levetiracetam, review
The role of non-epidemic viral encephalitis and HIV-infection in the development of acute epileptic seizures and epilepsy, analysis of recent epidemiological data and risk factors are discussed. Infections of the central nervous system produce up to 15 % of all types of new-onset symptomatic epileptic seizures. The risk depends on the ethology of infection, localization of lesion and severity. A high risk of development of epilepsy is seen in case of herpetic encephalitis and HIV-infection. The viral infections have been shown to be often accelerated by epileptic seizures in the acute phase of encephalitis and lead to an increased risk of developing epilepsy later. The mechanisms of development of early and late seizures are different. There are many forms of viral encephalitis, and all are associated to varying degrees with subsequent epilepsy. The risk of developing epilepsy following viral encephalitis is increased seven- to tenfold over premorbid levels. This risk increases the premorbid risk by 22 times if a patient experiences early seizures during the acute infection. Timely treatment of viral infections and early seizures reduces the risk of developing epilepsy later. The treatment of epileptic seizures due to viral infection is similar to those of symptomatic epilepsy. It is necessary to take into account possible drug-drug interactions between antiepileptic and antiviral drugs. Levetiracetam is used as an antiepileptic drug of the first choice in the treatment of epilepsy and epileptic seizures in the case of viral encephalitis.
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