We report a unique case of pseudotumour cerebri and herpes encephalitis
resulting due to isotretinoin.
Although a diagnosis of herpes encephalitis
may be confirmed by polymerase chain reaction (PCR), a comprehensive evaluation, including clinical findings, imaging, electroencephalography, and cerebrospinal fluid (CSF) results, should be performed to reach a possible diagnosis of PCR-negative viral encephalitis or another alternative diagnosis in cases with HSE-resembling encephalitis.
Caption: Figure 2: Coronal T2W-Fast spin echo (FSE) image showing hyper-intensity in the deep white matter of left temporal lobe with cortical thickening suggestive of Herpes encephalitis
Little et al., "Chronic cortical and subcortical pathology with associated neurological deficits ensuing experimental herpes encephalitis
," Brain Pathology, vol.
Kawakami et al., "A case of fatal herpes encephalitis
presenting massive cerebral hematoma," No Shinkei Geka.
is the most common sporadic cause of encephalitis worldwide.
Previously reported cases have demonstrated the ability of Gliomatosis Cerebri to mimic infective lesions such as acute diffuse encephalomyelitis, tuberculosis, Creutzfeldt-Jakob disease, and herpes encephalitis
. Although multifocal GBM can theoretically present as an infectious lesion, it is far less likely than Gliomatosis Cerebri to present in this fashion.
Fluid attenuated inversion recovery (FLAIR) MRI of herpes encephalitis
. J Comput Assist Tomogr.
Initial treatment included broad-spectrum antibiotics for presumed sepsis and acyclovir for suspected herpes encephalitis
Fluid attenuated inversion recovery (FLAIR), MRI of herpes encephalitis
. J Comput Assist Tomogr 1995; 19:501-505.
A neuropsychiatry assessment confirmed that this lady had acquired brain injury following Herpes encephalitis
. Single photon emission computed tomography (SPECT) showed extensive brain injury consistent with HSV.