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Atypical herpes type 2 encephalitis associated with normal MRI imaging
  1. N A Harrison1,
  2. B K MacDonald2,
  3. G Scott3,
  4. R Kapoor4
  1. 1Psychiatry, Maudsley Hospital, Denmark Hill, London, UK
  2. 2Neurology, Mayday Hospital, Croyden, Surrey, UK
  3. 3Microbiology, University College London Hospitals, UK
  4. 4Neurology, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
  1. Correspondence to Dr Kapoor, Neurology, National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK;


We describe a case of chronic atypical herpes simplex type 2 encephalitis in an immunocompromised 68 year old man presenting with headache and cognitive changes without focal neurological or MRI findings. To our knowledge this is the first described case of herpes simplex encephalitis associated with normal MRI brain imaging and non-focal neurological examination. This further expands the range of clinical presentations that may be associated with herpes simplex encephalitis and emphasises the value of PCR for herpes simplex virus in the investigation of encephalitis regardless of imaging findings.

  • herpes simplex
  • encephalitis
  • immunosuppression

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  • Competing interests: none declared