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Anterior opercular syndrome, caused by herpes simplex encephalitis
N M McGrath1, N E Anderson, J K Hope
1Department of Neurology, Auckland Hospital, New Zealand.
Neurology
|August 1, 1997
Summary
Anterior opercular syndrome, a condition causing facial and tongue muscle paralysis, can be an early sign of herpes simplex encephalitis (HSE). Prompt diagnosis of HSE is crucial for patients presenting with these neurological symptoms.
Area of Science:
- Neurology
- Infectious Diseases
Background:
- Bilateral opercular lesions can lead to anterior opercular syndrome, characterized by paralysis of masticatory, facial, pharyngeal, and tongue muscles.
- Herpes simplex encephalitis (HSE) is a severe neurological infection, often associated with significant morbidity.
Observation:
- The anterior opercular syndrome was observed in four patients with confirmed herpes simplex encephalitis (HSE).
- In some cases, anterior opercular syndrome was the primary clinical manifestation, while in others, it was overshadowed by broader HSE symptoms.
Findings:
- Herpes simplex virus (HSV) was confirmed as the causative agent in HSE patients via CSF analysis (DNA detection, antibody titers) and brain biopsy.
- The study highlights the link between anterior opercular syndrome and HSE, even when HSE diagnosis was not initially confirmed.
Implications:
- Acute onset of facial and tongue muscle weakness, especially with fever and seizures, should raise suspicion for HSE.
- Early recognition of anterior opercular syndrome as a potential HSE indicator can facilitate timely diagnosis and treatment, potentially improving patient outcomes.