title: The floccular syndrome in herpes simplex type 1 encephalitis.
abstract: A woman with herpes simplex virus type 1 (HSV1) encephalitis had downbeat nystagmus. The nystagmus was robust in primary gaze but attenuated during upgaze, suggestive of the flocculus involvement. FLAIR and T2-sequences of the brain MRI revealed cerebral lesions typical of HSV1, but also patchy hyperintensities in bilateral flocculi. Cerebrospinal fluid polymerase chain reaction confirmed HSV1 infection. Encephalopathy and downbeat nystagmus gradually improved with acyclovir therapy.
authors.affiliation: Department of Neurology, Case Western Reserve University, Cleveland, OH, United States. aasefshaikh@gmail.com
authors.forename: Aasef G
authors.initials: AG
authors.lastname: Shaikh
authors.forename: Pichet
authors.initials: P
authors.lastname: Termsarasab
authors.forename: David E
authors.initials: DE
authors.lastname: Riley
authors.forename: Bashar
authors.initials: B
authors.lastname: Katirji
mesh_terms: D020803:Encephalitis, Herpes Simplex / Q000150:complications* / Q000175:diagnosis*; D005260:Female; D006561:Herpes Simplex / Q000150:complications / Q000175:diagnosis; D018259:Herpesvirus 1, Human; D006801:Humans; D008875:Middle Aged; D009759:Nystagmus, Pathologic / Q000150:complications* / Q000175:diagnosis*