Herpes Simplex Encephalitis has been found to be one of the most common causes of fatal viral encephalitis (1). The mortality rate in untreated patients has been found to be as high as 70%, thus, correct management and early diagnosis are important for good prognoses and crucial for predicting outcomes. (1,2) In patients with Herpes Simplex Virus (HSV), specific findings such as the Periodic lateralized epileptic form discharges (PLEDs) are considered a specific finding on electroencephalogram (EEG). PLEDs are usually seen in the context of destructive structural lesions involving the cortex. Other causes may include acute ischemic stroke and, less commonly, tumors. This finding of PLEDs has been linked to epileptic seizures, including status epilepticus.(3)
We report a case of HSV type 2 infection and PLEDs as it is not a common presentation, unlike HSV type 1 infection.
Conflict(s) of Interest
References with DOI
1. Asnis D, Niazi N. Nondominant hemisphere encephalitis in patient with signs of viral meningitis. Emerging Infectious Diseases. 2009;15(8):1320-1321. https://doi.org/10.3201/eid1508.090466
2. Domingues RB, Tsanaclis AM, Pannuti CS, Mayo MS, Lakeman FD. Evaluation of the range of clinical presentations of herpes simplex encephalitis by using polymerase chain reaction assay of cerebrospinal fluid samples. Clin Infec Dis. 1997;25:86-91. https://doi.org/10.1086/514494
3. Beneto A, Gomez E, Rubio P, Sobrino R, Esparza A, Gil M. et al. Periodical EEG pattern modifications in herpetic encephalitis treated with acyclovir. Rev Neurol. 1996;24:829–832.
4. Ansari M K, Jha S. Herpes simplex encephalitis in a patient having common variable immuno-deficiency. Ann Trop Med Public Health. 2010;3:30-32. https://doi.org/10.4103/1755-6783.76183
Chuang, Justin and Shah, Sona K.
"Herpes simplex virus type II in a patient having Periodic Lateralized Epileptiform Discharges,"
Marshall Journal of Medicine:
1, Article 6.
Available at: http://mds.marshall.edu/mjm/vol3/iss1/6