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Atypical herpes simplex encephalitis

Clinical, virologic, and neuropathologic evaluation

Neurovirology Research Laboratory, Veterans Affairs Medical Center, Salt Lake City, UT (Dr. Rose)
Department of Neurology, University of Utah Medical School, Salt Lake City, UT (Drs. Rose and Matsuo)
Ophthalmology Research Laboratory, Veteran Affairs Medical Center, and Departments of Ophthalmology and Neurology, Baylor College of Medicine, Houston, TX (Dr. Stroop)
Division of Molecular Virology, Baylor College of Medicine, Houston, Tx (Dr. Stroop and Ms. Henkel).

An atypical form of herpes simplex encephalitis produced by HSV-1 documented in the present article demonstrates that (1) prominent EEG abnormality may correlate with subtle increase in signal intensity on MRI; (2) the disease may start with prominent involvement of the cingulate gyri; and (3) viral infection of the brainstem may cause early onset of severe neurologic dysfunction and coma.

Supported by the Medical Research Service of the Department of Veterans Affairs and Research Grant 1929-A-1 from the National Multiple Sclerosis Society. W.G.S. is supported in part by a Jules and Doris Stein Professorship awarded by Research to Prevent Blindness, Inc.

Address correspondence and reprint requests to Dr. John W. Rose, Neurovirology Research Laboratory (151B), VA Medical Center, 500 Foothill Drive, Salt Lake City, UT 84148.

Received November 6, 1991. Accepted for publication in final form February 11, 1992.

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