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Atypical herpes simplex encephalitis: clinical, virologic, and neuropathologic evaluation
J W Rose1, W G Stroop, F Matsuo
1Neurovirology Research Laboratory, Veterans Affairs Medical Center, Salt Lake City, UT 84148.
Neurology
|September 1, 1992
Summary
Atypical herpes simplex encephalitis (HSE) caused by HSV-1 can present subtly. Key indicators include EEG abnormalities, cingulate gyrus involvement, and brainstem infection leading to severe neurological issues.
Area of Science:
- Neurology
- Infectious Diseases
- Neuroimaging
Background:
- Herpes simplex encephalitis (HSE) is a severe neurological condition.
- Herpes simplex virus type 1 (HSV-1) is a common cause of HSE.
- Understanding atypical presentations is crucial for timely diagnosis and treatment.
Observation:
- This article documents an atypical form of HSE caused by HSV-1.
- The presentation involved subtle magnetic resonance imaging (MRI) signal intensity changes.
- Electroencephalography (EEG) showed prominent abnormalities.
Findings:
- A correlation was observed between prominent EEG abnormalities and subtle MRI signal increases.
- The encephalitis initially involved the cingulate gyri.
- Brainstem viral infection led to early, severe neurological dysfunction and coma.
Implications:
- Subtle MRI findings coupled with EEG changes can indicate atypical HSE.
- Early involvement of specific brain regions like the cingulate gyri and brainstem are critical diagnostic clues.
- Prompt recognition of these atypical signs is vital for managing severe neurological outcomes in HSV-1 encephalitis.