Temporal Lobe Encephalitis: Distinguishing Herpes Simplex Virus from Other Causes

Patients with herpes simplex encephalitis were more likely to present with symptoms lasting <1 week and less likely to have bilateral temporal lobe involvement.

Temporal lobe abnormalities are common in patients with herpes simplex encephalitis (HSE) but are not specific to that condition. Although computed tomography has not been useful in distinguishing other processes from HSE, magnetic resonance imaging (MRI) offers progress in this regard.

To explore the situation further, researchers retrospectively reviewed adult encephalitis cases with TL abnormalities on MRI, referred to the California Encephalitis Project between 1998 and 2012 (N=251). An infectious etiology was found in 108 (43%), including herpes simplex virus type 1 (HSV-1) in 57, HSV-2 in 3, Mycobacterium tuberculosis in 8, and varicella zoster virus in 7. A noninfectious cause was determined in 40 cases; no etiology was identified in …

Reviewing Author

Neil M. Ampel, MD

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Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)

Neil M. Ampel, MD

Disclosures

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)

Temporal Lobe Encephalitis: Distinguishing Herpes Simplex Virus from Other Causes

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Reviewing Author