Herpes simplex encephalitis Viral encephalitis is a serious neurological disorder associated with relatively poor outcome. Herpes simplex virus (HSV) encephalitis is the most common causative agent for viral encephalitis. More than 95% of HSV encephalitis is caused by HSV type 1. HSV 1 is transmitted primarily via saliva which subsequently enters the oral mucosa and spreads…
This cranial MRI is from a young woman who presented with low-grade fever, confusion, visual hallucinations and status epilepticus. Significant orofacial dyskinesias and autonomic dysfunction was also noted. Lumbar puncture was performed and cerebrospinal fluid (CSF) revealed mild lymphocytic predominant leukocytosis and slightly elevated protein. CSF glucose was within normal range and CSF for microbiological…
A middle-aged woman was admitted with drowsiness, weakness of all four limbs and visual impairment. Physical examination revealed that the patient had bilateral complete ophthalmoplegia, generalized weakness and spasticity,with brisk reflexes and bilateral upgoing plantar reflexes. A hyper-intense lesion at the level of the midbrain was noted on cerebral MRI (Figure 1). Cerebro-spinal fluid examination…
A. Clinical manifestations The clinical manifestations of encephalitis may be similar to those of meningitis. However, altered level of consciousness is a predominant sign. It can range from mild lethargy to deep coma. Moreover, focal or generalized seizures occur in many patients with encephalitis, especially in severe disease. Virtually every possible type of focal neurological…