Herpes simplex encephalitis relapses have been rarely reported, with only few cases occurring after neurosurgical interventions. A young man presented a late herpes simplex encephalitis relapse after left antero-mesial temporal resection for his refractory temporal lobe epilepsy. Eight days after surgery, he developed fever and aphasia. CSF PCR revealed more than 12,000 copies/ml of HSV-1 DNA. Intravenous acyclovir was immediately started with a complete recovery. Postoperative herpes simplex encephalitis can occur as primary infection or as relapse of previous infection. Surgical manipulation of brain parenchyma in the site of a previous infection can act as a trigger for viral reactivation. Early onset of antiviral therapy is fundamental and it is a strong predictor of clinical outcome. Despite no studies on prophylactic treatment with acyclovir in patients with previous herpes simplex encephalitis candidate to neurosurgery are available, we suggest that prophylactic treatment should be recommended.

中文翻译：

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癫痫手术后HSV-1脑炎复发：1例并文献复习。

鲜有单纯疱疹性脑炎复发的报道，只有少数病例在神经外科手术后发生。一名年轻男子因难治性颞叶癫痫病在左前颞颞叶切除后出现单纯疱疹性脑炎复发。手术八天后，他发烧并失语。CSF PCR显示超过12,000拷贝/ ml的HSV-1 DNA。立即开始静脉注射阿昔洛韦，完全恢复。术后单纯疱疹性脑炎可发生为原发感染或先前感染的复发。在先前感染部位进行脑实质的外科手术可触发病毒重新激活。抗病毒治疗的早期发作是基本的，并且是临床结果的有力预测指标。