Herpes simplex encephalitis mimicking mumps.
A 16-year-old male diabetic patient presented with bilateral salivary gland swellings followed by encephalitis. The EEG did not show the characteristic periodic lateralising epileptic discharges. Neuro-imaging disclosed compromise of temporal and frontal lobes as well as brain stem which correlated well with his clinical deterioration. Serology and frontal brain biopsy were positive for herpes simplex virus while mumps titers were not significant. Despite delayed acyclovir therapy, the patient recovered enough to be discharged home with a permanent pseudobulbar palsy. Herpes simplex encephalitis involving zones other than temporal lobes is exceptional. To our knowledge, there are no reported cases of pseudobulbar palsy as a sequelae of HSV encephalitis.
al Deeb
S M
SM
Department of Clinical Neurosciences, Riyadh Armed Forces Hospital, Saudi Arabia.
D000212:Acyclovir / Q000627:therapeutic use; D000293:Adolescent; D001706:Biopsy; D001921:Brain / Q000473:pathology; D001925:Brain Damage, Chronic / Q000175:diagnosis; D003937:Diagnosis, Differential; D004660:Encephalitis / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D005500:Follow-Up Studies; D006561:Herpes Simplex / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D007181:Inclusion Bodies, Viral / Q000648:ultrastructure; D008279:Magnetic Resonance Imaging; D008297:Male; D008854:Microscopy, Electron; D009107:Mumps / Q000175:diagnosis*; D009460:Neurologic Examination
D000212:Acyclovir