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Atypical herpes type 2 encephalitis associated with normal MRI imaging.
N A Harrison1, B K MacDonald, G Scott
1Psychiatry, Maudsley Hospital, Denmark Hill, London, UK.
Journal of Neurology, Neurosurgery, and Psychiatry
|June 18, 2003
Summary
Atypical herpes simplex encephalitis can occur in immunocompromised individuals, even with normal brain imaging and neurological exams. Polymerase chain reaction (PCR) testing is crucial for diagnosing herpes simplex virus (HSV) encephalitis.
Area of Science:
- Neurology
- Infectious Diseases
- Virology
Background:
- Herpes simplex virus (HSV) encephalitis is a serious neurological condition.
- Typical presentations often involve focal neurological deficits and characteristic MRI abnormalities.
Observation:
- A 68-year-old immunocompromised male presented with chronic headache and cognitive decline.
- The patient exhibited no focal neurological signs or abnormal MRI findings.
Findings:
- This case represents the first documented instance of HSV encephalitis with a normal brain MRI and non-focal neurological examination.
- Diagnosis was confirmed through polymerase chain reaction (PCR) testing for HSV.
Implications:
- This case broadens the spectrum of clinical presentations for HSV encephalitis.
- Highlights the importance of considering HSV PCR in encephalitis investigations, irrespective of imaging results.