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