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Related Concept Videos

Arboviral Encephalitis01:25

Arboviral Encephalitis

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Arboviral encephalitis refers to brain inflammation caused by arthropod-borne viruses, particularly those transmitted through mosquito vectors. Among these, West Nile virus (WNV), a member of the Flaviviridae family, is a significant public health concern. WNV is an enveloped, positive-sense, single-stranded RNA virus. Human infection typically begins when an infected mosquito introduces the virus into the dermis during feeding. The primary transmission cycle involves birds as amplifying hosts...
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Viral Meningitis01:18

Viral Meningitis

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Viral meningitis is the most common form of meningitis and is often referred to as aseptic meningitis to indicate the absence of bacterial involvement. It is generally milder than bacterial meningitis, with symptoms including fever, headache, stiff neck, drowsiness, nausea, photophobia, and vomiting. Rarely, more severe manifestations or death may occur. Common causative agents include enteroviruses, particularly coxsackie A and B viruses and echoviruses, all members of the Enterovirus genus...
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Herpes Simplex Viral Encephalitis Masquerading as a Classic Left MCA Stroke.

Peter A Abdelmalik1, Timothy Ambrose2, Rodney Bell2

  • 1Department of Anesthesia and Critical Care Medicine, Neurosciences Division, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.

Case Reports in Neurological Medicine
|January 16, 2016
PubMed
Summary

Herpes simplex viral encephalitis (HSVE) can mimic stroke symptoms, presenting with focal neurological deficits. Early diagnosis and treatment are crucial to reduce severe outcomes in patients with suspected stroke.

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Area of Science:

  • Neurology
  • Infectious Diseases

Background:

  • Stroke is diagnosed by acute focal neurological deficits, often in patients with vascular risk factors.
  • Herpes simplex viral encephalitis (HSVE) typically presents with fever, headache, and altered mental status.

Purpose of the Study:

  • To report a case of HSVE presenting with stroke-like symptoms.
  • To highlight the importance of considering HSVE in stroke mimics.

Main Methods:

  • A case report of a 79-year-old woman with hypertension, hyperlipidemia, and TIA.
  • Diagnostic workup included CT perfusion, CT angiogram, MRI brain, and EEG.
  • Cerebrospinal fluid (CSF) analysis with PCR confirmed HSVE.

Main Results:

  • Patient presented with global aphasia and right hemiparesis, initially suspected as MCA stroke.
  • Imaging and diffusion studies did not support a stroke diagnosis.
  • EEG showed periodic lateralized epileptiform discharges; CSF revealed pleocytosis and HSVE by PCR.

Conclusions:

  • HSVE can present with acute focal neurological signs mimicking stroke.
  • A high index of suspicion is necessary for timely diagnosis and treatment of HSVE.
  • Prompt management of HSVE is vital to decrease morbidity and mortality.