Correspondence Relapse and Movement Disorder After

To the Editor. We agree with Dr Barthez-Carpentier and her col-leagues ’ that the post-herpetic encephalopathy associated with a severe movement disorder should be recognized, since it is now described in several case reports including our own.2-5 However, Dr Barthez-Carpentier and her colleagues misquote our case report as suggesting that the clinical relapse might be a late symptom of the initial viral illness. In fact, we proposed that the movement dis-order was due to the combination of cortical necrosis and anti-convulsant treatment. Many of the previously reported pediatric patients who have had a severe movement disorder associated with a post-herpetic encephalopathy appear to have received anticonvulsant therapy. 2-5 Furthermore, a very similar complex movement disorder is described in children and adults with cortical damage from several different causes who were receiving phenytoin or carbamazepine.1 Because it appears that children with cortical damage following her-pes simplex encephalitis are at risk of an often intractable move-ment disorder if they receive anticonvulsants, we therefore suggested that the routine use of anticonvulsants, particularly phenytoin and carbamazepine, should be avoided. Did any of the children described by Dr Barthez-Carpentier and her colleagues receive anticonvulsants before their move-ment disorder began