Analysis of the role of viral encephalitis in the development of epileptic seizures and epilepsy




central nervous system, seizures, epilepsy, encephalitis, viral infections, pathogenesis, risk factors, forecasting, treatment, review


The aim – to determine the role of viral lesions of the central nervous system (CNS) in the development of epileptic seizures and epilepsy.

Materials and methods: analysis of scientific literature data. The review discusses the role of non-epidemic viral encephalitis and human immunodeficiency virus in the development of acute epileptic seizures and epilepsy; epidemiological data and risk factors.

Results. Viral infections are often complicated by acute (early) epileptic seizures and causes the risk of further epilepsy. The mechanisms of development of early and late seizures differ. Except herpetic encephalitis, in which risk of epilepsy in early seizures is up to 60 %, the risk of late seizures in other viral encephalitis hasn't been determined. Timely treatment of viral infections and early seizures reduces the risk of epilepsy. Treatment of epilepsy with infectious lesions of the central nervous system and other types of symptomatic epilepsy is similar, and the antiepileptic drug is determined by the semiology of seizures. The interaction between it and anti-infective drugs can change the concentration in the blood of each of them, which will lead to reduced effectiveness or toxicity. This is especially important for individuals with human immunodeficiency virus infection in whom antiretroviral drugs have significant interactions with antiepileptic drugs. Since epileptic activity of the brain is associated with the severity and complications of the underlying infection, early aggressive therapy prevents the development of late seizures and epilepsy.

Conclusions. CNS infections account for 15 % of all newly diagnosed symptomatic epileptic seizures. The 20-year risk of unprovoked seizures and epilepsy after CNS infections ranges from 2.4 % to 22 %. The risk depends on the etiology, location of the lesion and the severity; it is high in herpes-associated encephalitis

Author Biographies

Tetyana Litovchenko, Kharkiv Medical Academy of Postgraduate Education Amosova str., 58, Kharkiv, Ukraine, 61176

MD, Professor, Head of Department

Department of Neurology and Child Neurology

Oleksandr Bilchenko, Kharkiv Medical Academy of Postgraduate Education Amosova str., 58, Kharkiv, Ukraine, 61176

MD, Professor, Head of Department

Department of Therapy, Nephrology and General Practice-Family Medicine

Vladimir Malakhov, Kharkiv Medical Academy of Postgraduate Education Amosova str., 58, Kharkiv, Ukraine, 61176

MD, Professor, Head of Department

Department of Medical Rehabilitation, Sports Medicine and Physical Therapy

Olga Dubenko, Kharkiv Medical Academy of Postgraduate Education Amosova str., 58, Kharkiv, Ukraine, 61176

MD, Professor

Department of Neuropathology and Neurosurgery

Olga Sukhonosova, Kharkiv Medical Academy of Postgraduate Education Amosova str., 58, Kharkiv, Ukraine, 61176

MD, Professor

Department of Neurology and Pediatric Neurology

Viktoriia Bokatuieva, Institute of Neurology, Psychiatry and Narcology of National Academy of Medical Sciences of Ukraine Akademika Pavlova str., 46, Kharkiv, Ukraine, 61068


Department of Vascular Pathology of the Brain and Rehabilitation

Marianna Markova, Kharkiv Medical Academy of Postgraduate Education Amosova str., 58, Kharkiv, Ukraine, 61176

MD, Professor

Department of Sexology, Medical Psychology, Medical and Psychological Rehabilitation

Vadym Nikonov, Kharkiv Medical Academy of Postgraduate Education Amosova str., 58, Kharkiv, Ukraine, 61176

Doctor of medical sciences, professor, Head of the Department

Department of Emergency Care and Disaster Medicine


  1. World Health Organization. Epilepsy fact sheet no. 999 January 2009. Available at: t Last accessed: 23.10.2020
  2. Shorvon, S. D., Perukka, E., Engel, J. (Eds.) (2009). The treatment of epilepsy. Blackwell Publishing Ltd, 1075. doi:
  3. Sander, J. W., Hart, Y. M., Johnson, A. I., Shorvon, S. D. (1990). Medical science. National general practice Study of Epilepsy: newly diagnosed epileptic seizures in general population. Lancet, 336 (8726), 1267–1271. doi:
  4. Bhalla, D., Godet, B., Druet-Cabanac, M., Preux, P.-M. (2011). Etiologies of epilepsy: a comprehensive review. Expert Review of Neurotherapeutics, 11 (6), 861–876. doi:
  5. Fujiwara, T., Shigematsu, H. (2004). Etiologic factors and clinical features of symptomatic epilepsy: Focus on pediatric cases. Psychiatry and Clinical Neurosciences, 58 (3), S9–S12. doi:
  6. Singh, T. D., Fugate, J. E., Hocker, S. E., Rabinstein, A. A. (2014). Postencephalitic epilepsy: Clinical characteristics and predictors. Epilepsia, 56 (1), 133–138. doi:
  7. Ziai, W. C., Lewin, J. J. (2008). Update in the Diagnosis and Management of Central Nervous System Infections. Neurologic Clinics, 26 (2), 427–468. doi:
  8. Duncan, J. S., Shorvon, S. D., Fish, D. R. (1995). Clinical Epilepsy. London: Churchill Livingstone, 540.
  9. Shorvon, S. D., Andermann, F., Guerrini, R. (2011). The Causes of Epilepsy. Cambridge: Cambridge Univers. press, 787. doi:
  10. Annegers, J. F., Hauser, W. A., Beghi, E., Nicolosi, A., Kurland, L. T. (1988). The risk of unprovoked seizures after encephalitis and meningitis. Neurology, 38 (9), 1407–1410. doi:
  11. Cardarelli, W. J., Smith, B. J. (2010). The burden of epilepsy to patients and payers. The American Journal of Managed Care, 16, S331–S336.
  12. Marks, D. A., Kim, J., Spencer, D. D., Spencer, S. S. (1992). Characteristics of intractable seizures following meningitis and encephalitis. Neurology, 42 (8), 1513–1518. doi:
  13. Nieto Barrera, M. (2002). Aspectos clínicos, neurorradiológicos y evolutivos de las epilepsias catastróficas postencefalíticas. Revista de Neurología, 35 (S1), 30–38. doi:
  14. Trinka, E., Dubeau, F., Andermann, F. Bastos, A., Hui, A., Li, L. M. et. al. (2000). Clinical findings, imaging characteristics and outcome in catastrophic post-encephalitic epilepsy. Epileptic Disord, 2, 153–162.
  15. Chen, Y.-J., Fang, P.-C., Chow, J. C. (2006). Clinical Characteristics and Prognostic Factors of Postencephalitic Epilepsy in Children. Journal of Child Neurology, 21 (12), 1047–1051. doi:
  16. Zelano, J., Westman, G. (2020). Epilepsy after brain infections in adults: A register-based population-wide study. Neurology. doi:
  17. Granerod, J., Crowcroft, N. S. (2007). The epidemiology of acute encephalitis. Neuropsychological Rehabilitation, 17 (4-5), 406–428. doi:
  18. Singhi, P. (2011). Infectious causes of seizures and epilepsy in the developing world. Developmental Medicine & Child Neurology, 53 (7), 600–609. doi:
  19. Jmor, F., Emsley, H. C., Fischer, M., Solomon, T., Lewthwaite, P. (2008). The incidence of acute encephalitis syndrome in Western industrialised and tropical countries. Virology Journal, 5 (1), 134–136. doi:
  20. Whitley, R. J. (2006). Herpes simplex encephalitis: Adolescents and adults. Antiviral Research, 71 (2-3), 141–148. doi:
  21. Elbers, J. M., Bitnun, A., Richardson, S. E., Ford-Jones, E. L., Tellier, R., Wald, R. M. et. al. (2007). A 12-Year Prospective Study of Childhood Herpes Simplex Encephalitis: Is There a Broader Spectrum of Disease? Pediatrics, 119 (2), e399–e407. doi:
  22. Solomon, T., Hart, I. J., Beeching, N. J. (2007). Viral encephalitis: a clinical guide. Practical Neurology, 7, 288–305. doi:
  23. Yamada, S., Kameyama, T., Nagaya, S., Hashizume, Y., Yoshida, M. (2003). Relapsing herpes simplex encephalitis: pathological confirmation of viral reactivation. Journal of Neurology, Neurosurgery & Psychiatry, 74 (2), 262–264. doi:
  24. Kim, M. A., Park, K. M., Kim, S. E., Oh, M. K. (2008). Acute symptomatic seizures in CNS infection. European Journal of Neurology, 15, 38–41. doi:
  25. Doja, A., Bitnun, A., Ford Jones, E. L., Richardson, S., Tellier, R., Petric, M. et. al. (2006). Pediatric Epstein-Barr Virus – Associated Encephalitis: 10-Year Review. Journal of Child Neurology, 21 (5), 384–391. doi:
  26. Hung, K. L., Liao, H. T., Tsai, M. L. (2000). Epstein-Barr virus encephalitis in children. Acta Paediatr Taiwan, 41, 140–146.
  27. Häusler, M., Schaade, L., Kemény, S., Schweizer, K., Schoenmackers, C., Ramaekers, V. T. (2002). Encephalitis related to primary varicella-zoster virus infection in immunocompetent children. Journal of the Neurological Sciences, 195 (2), 111–116. doi:
  28. Perry, R. T., Halsey, N. A. (2004). The Clinical Significance of Measles: A Review. The Journal of Infectious Diseases, 189 (1), 4–16. doi:
  29. Cherry, J., Demmler-Harrison, G., Kaplan, Sh., Steinbach, W., Hotez, P. (2017). Feigin and Cherry's Textbook of Pediatric Infectious Diseases. Elsevier, 3000.
  30. Hviid, A., Rubin, S., Mühlemann, K. (2008). Mumps. The Lancet, 371 (9616), 932–944. doi:
  31. Vincent, A., Irani, S. R., Lang, B. (2011). Potentially pathogenic autoantibodies associated with epilepsy and encephalitis in children and adults. Epilepsia, 52, 8–11. doi:
  32. Granerod, J., Cunningham, R., Zuckerman, M., Mutton, K., Davies, N. W. S., Walsh, A. L. et. al. (2010). Causality in acute encephalitis: defining aetiologies. Epidemiology and Infection, 138 (6), 783–800. doi:
  33. Pillai, S. C., Mohammad, S. S., Hacohen, Y., Tantsis, E., Prelog, K., Barnes, E. H. et. al. (2015). Postencephalitic epilepsy and drug-resistant epilepsy after infectious and antibody-associated encephalitis in childhood: Clinical and etiologic risk factors. Epilepsia, 57 (1), e7–e11. doi:
  34. Armangue, T., Moris, G., Cantarín-Extremera, V., Conde, C. E., Rostasy, K., Erro, M. E. et. al. (2015). Autoimmune post–herpes simplex encephalitis of adults and teenagers. Neurology, 85 (20), 1736–1743. doi:
  35. Bradshaw, M. J., Pawate, S., Lennon, V. A., Bloch, K. C., Brown, K. M. (2015). Herpes simplex virus 1 encephalitis associated with voltage-gated calcium channel autoimmunity. Neurology, 85 (24), 2176–2177. doi:
  36. Titulaer, M. J., McCracken, L., Gabilondo, I., Armangué, T., Glaser, C., Iizuka, T. et. al. (2013). Treatment and prognostic factors for long-term outcome in patients with anti-NMDA receptor encephalitis: an observational cohort study. The Lancet Neurology, 12 (2), 157–165. doi:
  37. Spatola, M., Dalmau, J. (2017). Seizures and risk of epilepsy in autoimmune and other inflammatory encephalitis. Current Opinion in Neurology, 30 (3), 345–353. doi:
  38. Murthy, J. M. K., Prabhakar, S. (2008). Bacterial meningitis and epilepsy. Epilepsia, 49, 8–12. doi:
  39. Gaspard, N., Foreman, B. P., Alvarez, V., Cabrera Kang, C., Probasco, J. C. et. al. (2015). New-onset refractory status epilepticus: etiology, clinical features, and outcome. Neurology, 85, 1604–1613. doi:




How to Cite

Litovchenko, T., Bilchenko, O., Malakhov, V., Dubenko, O., Sukhonosova, O., Bokatuieva, V., Markova, M., & Nikonov, V. (2020). Analysis of the role of viral encephalitis in the development of epileptic seizures and epilepsy. ScienceRise: Medical Science, (6 (39), 4–9.



Medical Science