Non-convulsive status epilepticus as an initial manifestation of herpes simplex virus encephalitis

Herpes simplex encephalitis (HSVE), manifesting with non-convulsive status epilepticus (NCSE), normocellular CSF findings and CT features of acute ischemic stroke, is a rare finding that can be hard to diagnose accurately. We present a case of HSVE and compare our results to those of previously published cases with the same pathology, in order to provide information to support more rapid and effective diagnosis and treatment. A Pubmed search of reported cases was conducted and five cases of HSVE manifesting with NCSE were found. Each of the cases, including ours, was compared in terms of clinical manifestations and CSF, CT and EEG findings. The clinical manifestations in our patient correlated with those of the other cases. EEG showing sharp fronto-temporo-centro-parietal waves was only observed in our patient. Similar CT manifestations were found in one other patient, normocellular CSF was registered in three other cases and positive PCR for HSV in four patients. Information about the possible clinical manifestations and CT, EEG and CSF findings in patients with HSVE manifesting with NCSE is crucial for a fast diagnosis and successful treatment, leading to higher survival rates and fewer complications and neurological deficits.

Automated summary

Herpes simplex encephalitis (HSVE) presenting with non-convulsive status epilepticus (NCSE), normocellular CSF findings, and CT features of acute ischemic stroke is challenging to diagnose accurately. Comparison of multiple cases showed consistency in clinical manifestations, CSF, CT, and EEG results, highlighting the importance of understanding these factors for rapid diagnosis and successful treatment.