Herpes simplex encephalitis

Case contributed by Lana Rezan Pshtiwan
Diagnosis almost certain

Presentation

Disturbed level of consciousness, with seizure.

Patient Data

Age: 80 years
Gender: Male
mri

An abnormal signal involving left side medial temporal insular cortex and inferior and lateral side of the frontal lobe, and demonstrate high signal on T2/FLAIR, iso-intense on T1, faintly restricted on DWI/ADC mapping. No associated abnormal enhancement of the parenchyma or meninges, no hemorrhagic signal, these abnormal signals are sparing basal ganglia and not follow vascular territory.

Case Discussion

The patient had no history of fever at the early course of the illness , the CSF analysis was performed with the blood tests, and confirm our diagnosis of viral encephalitis, the patient responded dramatically to antiviral treatment.

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