Atypical herpes simplex encephalitis presenting as operculum syndrome.
This case report demonstrates the course of herpes simplex virus cerebritis in a patient aged 7 years 2 months who presented with non-specific symptoms followed by an epileptic attack. Subcortical, bilateral opercular and bilateral thalamic lesions were detected, but the temporal and inferior frontal lobes were spared. The patient developed anarthria, impairment of mastication and swallowing consistent with operculum syndrome. Diagnosis was made by magnetic resonance imaging and elevation of oligoclonal antibodies specific to herpes simplex virus in cerebrospinal fluid after an unexpectedly negative polymerase chain reaction test.
Wolf
R W
RW
Institut für Radiologie, Kantonsspital St. Gallen, Switzerland.
Schultze
D
D
Fretz
C
C
Weissert
M
M
Waibel
P
P
D000914:Antibodies, Viral / Q000032:analysis; D000998:Antiviral Agents / Q000627:therapeutic use; D001072:Apraxias / Q000175:diagnosis / Q000209:etiology*; D001921:Brain / Q000473:pathology; D002648:Child; D003680:Deglutition Disorders / Q000175:diagnosis / Q000209:etiology*; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D004401:Dysarthria / Q000175:diagnosis / Q000209:etiology*; D018792:Encephalitis, Viral / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D004827:Epilepsy / Q000175:diagnosis / Q000209:etiology; D005500:Follow-Up Studies; D006561:Herpes Simplex / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D018139:Simplexvirus / Q000276:immunology; D013577:Syndrome
D000914:Antibodies, Viral; D000998:Antiviral Agents