Presentation
History of herpes simplex encephalitis 3 years ago, now presenting with generalized tonic clonic seizures followed by postictal sleepiness and headache
Patient Data
There is right medial temporal lobe ill-defined cortical and subcortical cystic areas of encephalomalacia and gliosis following CSF signal intensity on all pulse sequences with surrounding T2/FLAIR patchy hyperintensities.
The right limbic system is also involved namely the hippocampus, parahippocampus, and the amygdala; with resultant volume loss and abnormal T2/FLAIR hyperintensities. Mild dilatation of the ipsilateral temporal horn of the right lateral ventricle is also noted. No restricted diffusion.
The right basal ganglia is spared.
Case Discussion
Here is an example of a chronic outcome of adult herpes simplex encephalitis with cystic encephalomalacia and volume loss in the affected areas resulting in seizures.
Additional contributors, the neurologists, Dr. Abdelmonem Mohamed Aboali and Dr. Alaa Meshaal.
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