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Herpes simplex encephalitis presenting with exclusively frontal lobe involvement

Sean W Taylor1, Donald H Lee, Alan C Jackson

  • 1Department of Medicine (Neurology), Queen's University, Kingston, Ontario, Canada.

Journal of Neurovirology
|November 13, 2007
PubMed

Insights

Herpes simplex encephalitis can present with frontal lobe lesions on MRI, not just temporal. Early diagnosis and treatment with intravenous acyclovir are crucial for recovery.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Neuroimaging

Background:

  • Herpes simplex encephalitis (HSE) is a severe neurological condition.
  • Typical MRI findings often involve temporal lobe lesions.
  • Diagnosis can be challenging with atypical presentations.

Observation:

  • This report details a patient with HSE exhibiting MRI lesions solely in the frontal lobes, including the anterior cingulate gyri.
  • The patient recovered well with intravenous acyclovir treatment.
  • A prior case with similar frontal lobe involvement resulted in a fatal outcome.

Findings:

  • Atypical frontal lobe involvement in HSE is possible.
  • Extratemporal limbic system structure lesions can occur.
  • MRI findings in HSE can vary significantly.

Implications:

  • Clinicians should maintain a high index of suspicion for HSE in patients with fever and extratemporal brain lesions.
  • Frontal lobe lesions on MRI warrant consideration for HSE, even without typical temporal involvement.
  • Prompt diagnosis and treatment are vital for improving patient outcomes in HSE.

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