Sudden ‘Stroke-Like’ Onset of Hemiparesis Due to Herpetic Encephalitis

Abstract

Herpes simplex encephalitis usually has a progressive cause. Sudden neurological deficits are unusual. Case study. 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 hepetic encephalitis was made by magnetic resonance imaging (MRI) and by the significant increase in cerebrospinal fluid titres of antibodies against herpes simplex type I. 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. © 1995, Canadian Neurological Sciences Federation. All rights reserved.