Suspected Herpes Encephalitis and Opercular Syndrome in Childhood

• Published in: Pediatric neurology Vol. 36; no. 3; pp. 202 - 206
• Main Authors: García-Ribes, Ainhoa, MD, Martínez-González, María Jesús, MD, Prats-Viñas, Jose María, MD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-03-2007; Elsevier
• Subjects: Biological and medical sciences; Encephalitis, Herpes Simplex - complications; Encephalitis, Herpes Simplex - diagnosis; Encephalitis, Herpes Simplex - therapy; Female; Human viral diseases; Humans; Infant; Infant, Newborn; Infectious diseases; Male; Masticatory Muscles; Medical sciences; Movement Disorders - virology; Neurology; Pediatrics; Syndrome; Viral diseases; Viral diseases of the nervous system; Viral diseases with cutaneous or mucosal lesions and viral diseases of the eye; Human; Infection; Encephalitis; Nervous system diseases; Viral disease; Central nervous system disease; Herpes; Child; Cerebral disorder
• ISSN: 0887-8994; 1873-5150
• DOI: 10.1016/j.pediatrneurol.2006.10.006

Herpes simplex encephalitis is the most common form of sporadic viral encephalitis. It may occur at any age, giving rise to a syndrome with a high morbidity and mortality. Its presentation may be atypical, and the initial complementary investigations nonspecific, making early diagnosis difficult and thus worsening its prognosis. This report describes four infants with herpes encephalitis presenting with an opercular syndrome that left significant sequelae after the acute episode. The opercular syndrome is characterized clinically by a disturbance of voluntary control of the facio-linguo-glosso-pharyngeal muscles, affecting speech and swallowing. Recognition of the opercular syndrome as a form of presentation of herpes encephalitis enables early diagnosis to be made in these patients, with the rapid initiation of treatment with acyclovir, improving the clinical course.