Association of herpes simplex virus encephalitis and paraneoplastic encephalitis - A clinico-pathological study

A 57 year-old woman developed acute limbic encephalitis and brainstem dysfu nction. Anti-HU antibodies were repeatedly detected in serum and CSF. Postm ortem examination showed necrotic and hemorrhagic lesions in the temporal l obes characteristic of herpes simplex virus encephalitis, which was confirm ed by immunocytochemistry, and Purkinje cell loss with proliferation of Ber gman glia and myelin loss in the external aspect of the dentate nuclei char acteristic of paraneoplastic encephalitis. PCR-assay performed on temporal tissue extracts was positive for HSV-1. There was no identifiable neoplasm. This unusual association raises the possibility of a link between the two diseases.