Abstract

Herpes simplex encephalitis (HSE) is a leading cause of sporadic, non-epidemic viral encephalitis in children and adults. We report a very rare case of HSE complicated by multiple ischaemic infarcts involving both basal ganglia in a 15-year-old female adolescent admitted with complaints of headache and fever, irrational behavior and seizures. On clinical examination patient was unconscious with signs of raised intracranial pressure, right hemiparesis and meningeal irritation. She had elevated temperature (38.7°C), and anaemia (packed cell volume of 25.0%). Magnetic resonance imaging showed features of Multiple non-enhancing hypodensities in both basal ganglia with mild dilation of the 3rd and lateral ventricles. She was managed as a case of Post-encephalitis Basal ganglia stroke. The patient subsequently developed a repeat vascular event, with suspected haemorrhagic transformation after 4 weeks and succumbed to the illness.

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