Herpes simplex encephalitis

Case contributed by Dr Ahmed Abd Rabou

Presentation

Attacks of fever and convulsion of 1 week duration

Patient Data

Age: 7 months old
Gender: Male
MRI

Multifocal cortical and subcortical hemorrhagic patches in early subacute stage displaying high T1 and low T2 signal with restricted diffusion in DWI. The largest lesion involves the right temporal lobe. Involutional brain changes are noted. MRV is unremarkable. 

Case Discussion

Herpes simplex virus causes hemorrhagic encephalitis. Its usually affect the medial temporal lobe however its pattern in children and infant is atypical as it becomes multifocal involving any cerebral area sparing the basal ganglia.Other differential diagnosis includes hemorrhagic infarction, post ictal changes and neoplastic lesion. 
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Case information

rID: 25468
Case created: 26th Oct 2013
Last edited: 31st May 2017
Inclusion in quiz mode: Included

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