Recurrent Transcortical Motor Aphasia—Another CNS Infectious Syndrome Associated with Herpes Virus Infection

Abstract

Herpes simplex encephalitis is an acute/subacute illness that causes both general and focal signs of cerebral
dysfunction with fever, headache, and confusion as cardinal features. Recurrent herpes simplex meningitis,
also known as Mollaret’s meningitis, is another manifestation of central nervous system herpetic infection
with recurrent episodes of fever, headache, and nuchal rigidity associated with cerebrospinal fluid (CSF)
evidence of active herpes simplex infection. Bell’s palsy is yet another manifestation of a herpes virus
infection in at least some reported cases documented by CSF analysis. We report a case of a 70-year-old
male who presented with acute transcortical motor aphasia initiating a stroke work-up that was negative.
Physical examination revealed genital vesicles, and the CSF was consistent with active herpes simplex
infection.