Caspr2 antibodies in herpes simplex encephalitis: an extension of the spectrum of virus induced autoimmunity? – A case report

Abstract

Background: Post herpes simplex virus (HSV) autoimmune encephalitis has been reported mainly in association with NMDA receptor antibodies, however, never with Caspr2 antibodies. Case presentation: We report an 82-year old female patient with encephalitis who presented with aphasia, left temporo-mesial hyperintense lesion on MRI, epileptiform discharges on spot electroencephalography, cerebrospinal fluid (CSF) lymphocytic pleocytosis and who showed positive HSV polymerase chain reaction in CSF as well as antibodies against contactin-associated protein-like 2 (Caspr2). Conclusion: This is the first report of a patient with encephalitis who tested positive for HSV as well as for Caspr2 antibodies.