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MRI findings of recurrent herpes simplex encephalitis in an infant

Aya M Tokumaru1, Katsuyuki Horiuchi, Tatsumi Kaji

  • 1Department of Radiology, National Defence Medical College, 3-2 Namiki-Cho, 359-8513, Tokorozawa, Saitama, Japan. ayasan@ndmc.ac.jp

Pediatric Radiology
|July 25, 2003
PubMed

Insights

Recurrent herpes simplex encephalitis (HSE) may be more common in infants. MRI findings in infant HSE differ from older patients, highlighting the need for early consideration of recurrent HSE.

Area of Science:

  • Neurology
  • Pediatrics
  • Radiology

Background:

  • Herpes simplex encephalitis (HSE) is a severe neurological condition.
  • Recurrent HSE is less understood, particularly in infants.

Observation:

  • A 2-year-old boy presented with recurrent HSE.
  • Initial symptoms included prolonged fever without adequate treatment.
  • Subsequent MRIs revealed progressive temporal lobe atrophy and cortical swelling.

Findings:

  • MRI demonstrated marked atrophic changes in deep temporal lobes with hippocampal hyperintensity.
  • Later MRI showed diffuse cortical swelling and bilateral occipito-parietal T2 hyperintensity.
  • Specific findings included left thalamus, subcortical white matter, and corpus callosum involvement.

Implications:

  • Recurrent HSE might be more prevalent in infants than previously recognized.
  • Infant HSE MRI findings vary significantly from neonates, children, and adults.
  • Clinicians should consider recurrent HSE in infants with suggestive symptoms and distinct MRI patterns.

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