Herpes encephalitis

Case contributed by Dr Amro Omar

Presentation

Lethargy, apnea, poor feeding and seizures.

Patient Data

Age: 1 year
Gender: Female
MRI

Initial study

There is bilateral asymmetric increased signal intensity in FLAIR sequence with corresponding diffusion restriction on DWI in anterior and medial temporal lobes, limbic systems, right insular cortex and fornix, right pulvinar.  Basal ganglia are spared.  Increased signal also noted in anterior commissure.

Overall pattern of abnormality is bilateral, and not fitting a single vascular distribution.

MRI

Follow-up,one month later

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

Case Discussion

This case was managed as herpes simplex encephalitis

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Case information

rID: 32437
Published: 26th Nov 2014
Last edited: 1st Jul 2018
Inclusion in quiz mode: Included

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