Images in neuroscienceImages in neuroscience
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The most likely diagnosis: (MRI – T2-weighted spin echo, DWI, and axial post-contrast scans)
- (a)
Glioblastoma multiforme
- (b)
HSV encephalitis
- (c)
Progressive multifocal leukoencephalopathy
- (d)
Equine encephalitis
- (e)
Lymphoma
Answer
(b) HSV encephalitis
Other investigations
Lumbar puncture: 360 lymphocytes; HSV 1 PCR positive.
EEG: Generalised encephalopathy with slowing and occasional sharp theta transients in the right anterior temporal region.
Neuropsychology 1 week later: Decreased immediate attention, slowed processing of information, reduced verbal reasoning ability and visuo-constructional skills.
Case prepared by Dr. Sandra Petty and Dr. Peter Mitchell, Neurosciences, Royal Melbourne Hospital.
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