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Case Reports
. 2025 Mar;32(3):e70059.
doi: 10.1111/ene.70059.

Teenager Febrile Dystextia

Florian Perrin de Brichambaut  1 , Gabrielle Dupuy  2 , Eugénie Sarda  2 , Nathalie Boddaert  3 , Charles-Joris Roux  3 , Ivana Dabaj  1 , Stéphane Marret  1 , Mélodie Aubart  3 , Isabelle Desguerre  2
Affiliations
Case Reports

Teenager Febrile Dystextia

Florian Perrin de Brichambaut et al. Eur J Neurol. 2025 Mar.

Abstract

Introduction: Dystextia refers to a kind of aphasia. It is the inability or the difficulty to text with a mobile phone. It has been described 15 years ago in central neurologic pathologies like stroke, migraine with aura, neurologic tumor disease.

Case presentation: We report the case of a 15-year-old boy who presented a febrile dystextia with acute insular lobes lesions in MRI. Human Simplex Virus 1 and lymphocytosis were present in the CSF and intravenous treatment with aciclovir has been initiated. Clinical signs were completely reversible.

Discussion: This case enhances the importance of emerging symptoms related to the common use of 21st century technology-such as smartphones-especially among younger patients. It also corroborates the association between the insular lobe and dystextia.

Conclusion: This is the first report of herpetic meningoencephalitis revealed through febrile dystextia in a child.

Keywords: encephalitis; infectious diseases; stroke.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Cerebral MRI. Images are made at 2 levels in diffusion‐weighted sequence (A, E), Flair (C, G) and T1 weighted images after gadolinium injection (D, H). Images B and F represent the apparent diffusion coefficient (ADC). Images I and J are performed one month later on Flair sequence. On top, at the level of the gray nuclei and on the bottom at the level of the lateral ventricles: Multiple small bilateral insular (arrows A) and bilateral fronto‐parietal (arrows E) scattered hypersignals are noted on diffusion‐weighted images, accompanied by a corresponding decrease apparent diffusion coefficient (B, F) reflecting cytotoxic edema and a flair hyper signal (C, G). A contrast enhancement on T1 post contrast weighted images is noted corresponding to a rupture of the blood–brain barrier (D, H). After one month (I, J), scattered hypersignals are noted on cortical Flair weighted images (arrows) whereas diffusion‐weighted images are normal. Furthermore, we noticed laminar cortical necrosis in T1 in a very small area of the left parietal cortex (nowhere else to be seen), consistent with patient's clinical improvement and early treatment.
See this image and copyright information in PMC

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