Herpes simplex encephalitis-sequelae

Case contributed by Dr Mohamed Saber

Presentation

History of herpes simplex encephalitis 3 years ago, now presenting with generalized tonic colonic seizures followed by postictal sleepiness and headache

Patient Data

Age: 25 years
Gender: Male

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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Case information

rID: 89719
Published: 18th May 2021
Last edited: 21st May 2021
Inclusion in quiz mode: Included
Institution: Faculty of medicine Al-Azhar University

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