an unusual presentation of idiopathic hypereosinophilic syndrome

Hypereosinophilic syndrome (hes) is a rare but life-threatening multi-organ disease which can be complicated by stroke, with devastating outcomes. eosinophils can accumulate in multiple organs, most commonly involving the heart, skin, lungs, spleen, and liver. neurological end-organ complications in hypereosinophilic syndrome are unusual and have been established to be of three types: brain infarction, encephalopathy and sensory polyneuropathy. we present a case where acute ischaemic stroke and encephalopathy are early manifestations of idiopathic hes. it is important to consider hes as an aetiology for stroke and a high eosinophil count is an initial diagnostic clue. early initiation of steroid therapy can potentially prevent disease progression.