Herpes simplex encephalitis presenting with exclusively frontal lobe involvement.
The authors report a patient with herpes simplex encephalitis who presented with magnetic resonance imaging (MRI) lesions exclusively in the frontal lobes, including the bilateral anterior cingulate gyri. She is making a good recovery after therapy with intravenous acyclovir. A similar presentation with a fatal outcome was previously reported by Rose et al (Neurology 42: 1809-1812, 1992). MRI shows temporal lesions in most patients with herpes simplex encephalitis, whereas occasional patients have normal imaging. A high index of suspicion for the diagnosis of herpes simplex encephalitis should be maintained when a patient presents with fever and brain lesions involving extratemporal limbic system structures.
Taylor
Sean W
SW
Department of Medicine (Neurology), Queen's University, Kingston, Ontario, Canada.
Lee
Donald H
DH
Jackson
Alan C
AC
D000328:Adult; D003937:Diagnosis, Differential; D020803:Encephalitis, Herpes Simplex / Q000473:pathology*; D005260:Female; D005625:Frontal Lobe / Q000473:pathology* / Q000821:virology; D007839:Functional Laterality; D006801:Humans; D008279:Magnetic Resonance Imaging