Sudden 'stroke-like' onset of hemiparesis due to herpetic encephalitis.

BACKGROUND/OBJECTIVE: Herpes simplex encephalitis usually has a progressive cause. Sudden neurological deficits are unusual.

METHOD

Case study.

RESULTS

A 17-year-old girl presented with an acute onset focal neurological deficit followed one week later by the more classical feature of altered level of consciousness, fever and focal seizures. The diagnosis of herpetic encephalitis was made by magnetic resonance imaging (MRI) and by the significant increase in cerebrospinal fluid titres of antibodies against herpes simplex type I.

CONCLUSION

Herpetic encephalitis should be considered in the differential diagnosis of acute stroke in young patients even in the absence of encephalitic features, if common etiological factors such as embolization and intracerebral bleed are excluded.