Hostname: page-component-586b7cd67f-t7fkt Total loading time: 0 Render date: 2024-11-26T06:50:37.505Z Has data issue: false hasContentIssue false
  • English
  • Français

Sudden ‘Stroke-Like’ Onset of Hemiparesis Due to Herpetic Encephalitis

Published online by Cambridge University Press:  18 September 2015

Mohammad AbdulJabbar ,
Ibrahim Ghozi ,
Anwar Haq  and
Hanz Korner
Mohammad AbdulJabbar*
Affiliation:
Division of Neurology, Khalid University Hospital, Riyadh, Saudi Arabia
Ibrahim Ghozi
Affiliation:
Division of Neurology, Security Forces Hospital, Riyadh, Saudi Arabia
Anwar Haq
Affiliation:
Division of Neurology, Security Forces Hospital, Riyadh, Saudi Arabia
Hanz Korner
Affiliation:
Division of Neurology, Security Forces Hospital, Riyadh, Saudi Arabia
*
Associate Professor, Neurology Unit, King Khalid University Hospital, P.O. Box 7805[38], Riyadh 11472, Saudi Arabia
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Background/Objective

Herpes simplex encephalitis usually has a progressive cause. Sudden neurological deficits are unusual.

Method

Case study.

Results

A 17-year-old girl presented with an acute onset focal neurological deficit followed one week later by the more classical feature of altered level of consciousness, fever and focal seizures. The diagnosis of hepetic encephalitis was made by magnetic resonance imaging (MRI) and by the significant increase in cerebrospinal fluid titres of antibodies against herpes simplex type I.

Conclusion

Herpetic encephalitis should be considered in the differential diagnosis of acute stroke in young patients even in the absence of encephalitic features, if common etiological factors such as embolization and intracerebral bleed are excluded.

Résumé

Résumé<span class='italic'><span class='bold'>Introduction et objectif</span></span>

Nous décrivons un cas d’encéphalite, due au virus de l’herpès simplex, dont le mode de présentation clinique a été inhabituel par le début subit de l’hémiparésie, à la façon d’un ictus cérébral.

<span class='italic'><span class='bold'>Méthode</span></span>

Une jeune fille de 17 ans a présenté un déficit neurologique suivi, une semaine plus tard, par les manifestations plus classiques: une altération de la conscience, de Phyperthermie et des convulsions focales.

<span class='italic'><span class='bold'>Résultat</span></span>

Le diagnostic reposait sur les manifestations observées à l’imagerie par résonance magnétique (MRI) et sur l’augmentation significative des titres d’anticorps contre le virus de l’herpès simplex I dans le liquide céphalo-rachidien.

<span class='italic'><span class='bold'>Conclusions</span></span>

L’encéphalite herpétique devrait être incluse dans le diagnostic différentiel de l’ictus cérébral aigu chez le jeune patient, même en l’absence de manifestations d’encéphalite, si les principaux facteurs étiologiques courants, tels l’embolie ou l’hémorragie intracérébrale, ont été exclus.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 22 , Issue 4 , November 1995 , pp. 320 - 321
Copyright
Copyright © Canadian Neurological Sciences Federation 1995

References

REFERENCES

1. Black, FL. Infectious disease in primitive societies. Science 1975; 18(7): 515.Google Scholar
2. Whitley, RJ, Schlitt, M. Encephalitis caused by herpes viruses, including B virus infections of the central nervous system. In: Scheld, WM, Whitleys, RJ, Durack, DT, eds. New York: Raven Press, 1991; 41–86.Google Scholar
3. Schroth, G, Gawehn, J, Thron, A, Vallbracht, A, Voigt, K. Early diagnosis of herpes simplex encephalitis by MRI. Neurology 1987; 37: 179–183.CrossRefGoogle ScholarPubMed
4. Nahmias, AJ, Whitley, RJ, Visintine, AN, et al. Herpes simplex virus encephalitis: laboratory evaluations and their diagnostic significance. J Infect Dis 1982; 145: 829–836.Google Scholar
5. Whitley, RJ. Herpes simplex virus infection of the central nervous system. Am J Med 1988; 85 (S2A): 61–67.Google Scholar
6. Longson, M. The general nature of viral encephalitis in the United Kingdom. In: lilis, LS, ed. Viral Diseases of the Central Nervous System. London: Balliere, Tindall, 1975; 19–31.Google Scholar
7. Skoldenberg, B, Alestig, K, Burman, L, et al. Acyclovir versus vidarabine in herpes simplex encephalitis. A randomized multicentre study in consecutive Swedish patients. Lancet 1984; 2: 707–711.Google Scholar
8. Corey, L, Spear, PG. Infections with herpes simplex viruses II. N Engl J Med 1986; 314: 749–757.Google Scholar
9. Whitley, RJ, Cobbs, CG, Alford, CA, et al. Diseases that mimic herpes simplex encephalitis. JAMA 1989; 262: 234–239.Google Scholar
10. Whitley, RJ. Viral encephalitis. N Engl J Med 1990; 323: 242–250.CrossRefGoogle ScholarPubMed
11. Fletcher, NA, Sharief, M, Kocen, RS. Herpes simplex encephalitis without CSF leucocytosis. Postgrad Med J (Letter) 1992; 68: 229–231.CrossRefGoogle ScholarPubMed
12. Schlageter, N, Jubelt, B, Vick, NA. Herpes simplex encephalitis without CSF leukocytosis. Arch Neurol 1984; 41: 1007–1008.CrossRefGoogle ScholarPubMed