Fisahn C, Tkachenko L, Moisi M, Rostad S, Umeh R, Zwillman ME, Tubbs RS, Page J, Newell DW, Delashaw JB.Herpes Simplex Encephalitis of the Parietal Lobe: A Rare Presentation.Cureus. 2016 Sep 16;8(9):e785.
A 69-year-old female with a history of breast cancer and hypertension presented with a rare case of herpes simplex encephalitis (HSE) isolated to her left parietal lobe. The patient's first biopsy was negative for herpes simplex virus (HSV) I/II antigens, but less than two weeks later, the patient tested positive on repeat biopsy. This initial failure to detect the virus and the similarities between HSE and symptoms of intracranial hemorrhage (ICH) suggests repeat testing for HSV in the presence of ICH. Due to the frequency of patients with extra temporal HSE, a diagnosis of HSE should be more readily considered, particularly when a patient may not be improving and a concrete diagnosis has not been solidified.