MR Study of Child Discloses Bilateral Papilledema and Optic Nerve Swelling. CSF Examination Positive for HSV-1 DNA. Could This Be a Rare Primary Manifestation of Herpes Infection?

We describe a rare case of bilateral papilledema and optic nerve swelling in a young patient with bilateral loss of visual acuity five days after onset of muscle contraction and pain involving the neck and right upper and lower limbs. This rare finding may be a possible first manifestation in a human patient of viral disease linked to HSV-1. MR study confirmed edema of the optic disc and evidence of optic nerve swelling. PCR for HSV-1 DNA was positive in the cerebrospinal fluid.