Author Affiliation: Department of Neurology, Johns Hopkins Bayview Medical Center, Baltimore, Maryland.
Sethi and Schmidley1 comment in their report of 3 cases of cerebral infarcts in the setting of eosinophilia that neurological problems in hypereosinophilic syndrome (HES) include stroke, neuropathy, and encephalopathy. They note that the strokes are small and occur in the arterial border zones but may progress. Specifically, they comment that generalized encephalopathy occurs in a small percentage of patients with HES,2 producing behavioral disturbances and upper motor neuron signs. An early report showed that 3 patients with encephalopathy had multiple lesions in the border zones, worsened with higher eosinophil counts, and improved with treatment.3 Sethi and Schmidley speculate that HES encephalopathy is due to multiple small cerebral artifacts.
Kaplan PW. Central Nervous System Problems With Eosinophilia. Arch Neurol. 2011;68(12):1613-1614. doi:10.1001/archneur.68.12.1613