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Year : 2021  |  Volume : 69  |  Issue : 4  |  Page : 1133--1134

Cortical Laminar Necrosis in HSV-1 Encephalitis

Abhishek Juneja, Kuljeet S Anand 
 Department of Neurology, Dr. RML Hospital, New Delhi, India

Correspondence Address:
Abhishek Juneja
A-15, Old Quarters, Ramesh Nagar, New Delhi - 110 015

How to cite this article:
Juneja A, Anand KS. Cortical Laminar Necrosis in HSV-1 Encephalitis.Neurol India 2021;69:1133-1134

How to cite this URL:
Juneja A, Anand KS. Cortical Laminar Necrosis in HSV-1 Encephalitis. Neurol India [serial online] 2021 [cited 2021 Dec 3 ];69:1133-1134
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Magnetic resonance imaging (MRI) is the neuroimaging study of choice in the evaluation of encephalitis. MRI is the most sensitive and specific imaging method for herpes simplex virus encephalitis, particularly early in the course of the illness.[1] Typical findings on MRI include asymmetric hyperintense lesions on T2-weighted sequences corresponding to areas of edema in the mesiotemporal and orbitofrontal lobes and the insular cortex.[2] Common differential diagnoses to be considered are infarct and status epilepticus. Infarct follows a vascular territory besides having a distinct clinical presentation. Status epilepticus presents unilaterally and typically involves mainly the cortex with widespread postictal edema.

Accumulating evidence suggests that diffusion restriction on diffusion-weighted imaging is frequently seen early in the course of Herpes Simplex Virus Encephalitis (HSVE) and may be among the earliest neuroradiologic manifestations.[3] We had a 22-year-old male patient who had fever for 7 days followed by altered sensorium with multiple episodes of generalized tonic clonic seizures for 2 weeks. His MRI brain showed T2/fluid-attenuated inversion recovery asymmetric bilateral temporal, insular and basifrontal hyperintensities with cortical laminar necrosis in right temporal lobe [Figure 1], [Figure 2], [Figure 3]. Herpes Simplex Virus 1 (HSV 1) was detected in cerebrospinal fluid using polymerase chain reaction.{Figure 1}{Figure 2}{Figure 3}

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