Successful and rapid recovery of HSV-1 DNA from the cerebrospinal fluid after amplification by polymerase chain reaction was obtained in a 7-year-old boy with subtotal and permanent upper extremity paralysis with rapid onset and magnetic resonance imaging evidence of cervical cord involvement. Early administration of intravenous acyclovir probably limited neuronal loss. The clinical course and outcome of this disorder best conformed with what has been described as poliomyelitis-like paralysis associated with respiratory tract infection (Hopkins syndrome).