Generalized Epilepsy with Right Hemiparesis Secondary to Herpes Encephalitis

International Journal of Medical and Pharmaceutical Case Reports

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Title Generalized Epilepsy with Right Hemiparesis Secondary to Herpes Encephalitis
Creator Lwin, Htay
Naing, Zay Yar
Soe, Htoo Htoo Kyaw
Abas, Adinegara Lutfi
Moe, Soe
Htay, Mila Nu Nu
Description Herpes simplex encephalitis (HSE) is a medical emergency associated with high mortality and morbidity. Definitive diagnosis is established by history, clinical examination, neuroimaging studies, supportive electroencephalogram (EEG) findings, and cerebrospinal fluid (CSF) analysis.
A 7-year-old Malay girl with known case of right hemiplegia secondary to herpes encephalitis presented to the neuropediatric ward, in General Hospital with refractory seizure. She had a moderate learning disability and diagnosed as right hemiparesis secondary to herpes encephalitis complicated with epilepsy. She was planned for the positron emission tomography (PET) scan and to undergo operation if PET scan was feasible (Hemispherectomy). However, the patient refused for operation.
Prompt clinical recognition is important in the HSE to prevent progressive brain tissue damage, haemorrhagic changes, and worsening of the encephalitis. Diagnosis is usually confirmed through an extensive evaluation, including a thorough clinical examination with attention to findings on mental status changes, cerebrospinal fluid (CSF) analysis, electroencephalogram (EEG) testing and findings on neuroimaging.
Once HSE is suspected, high-dose acyclovir should be started immediately before lumbar puncture (LP), and only stopped once a definitive alternate diagnosis has been established.
This case is reported because the patient has generalized epilepsy with right hemiparesis secondary to herpes encephalitis. Herpes encephalitis with right hemiparesis cases are quite rare.
Publisher SCIENCEDOMAIN international
Date 2020-10-01
Type info:eu-repo/semantics/article
Format application/pdf
Source International Journal of Medical and Pharmaceutical Case Reports; 2020 - Volume 13 [Issue 2]; 9-13
Language eng
Rights Copyright (c) 2020 © 2020 Lwin et al.; This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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