Herpes encephalitis

Case contributed by Dr Amro Omar

Presentation

Lethargy, apnea, poor feeding and seizures.

Patient Data

Age: 1
Gender: Female
MRI

There is bilateral asymmetric increased signal intensity in FLAIR sequence with corresponding diffusion restriction on DWI in anterior and medial temporal lobes as well as limbic systems, right more than left. There is also abnormal signal noted in right insular cortex and right fornix. Basal ganglia are spared. 

Increased signal also noted in anterior commissure.  

MRI

One month later.

Dramatic change in one month with cystic encephalomalacia, focal atrophy and white matter hyperintensity.

Case Discussion

This case was managed as an herpes simplex encephalitis

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Case information

rID: 32437
Case created: 26th Nov 2014
Last edited: 1st Oct 2015
Inclusion in quiz mode: Included

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