49 year old man presenting with strange behavior

Erin Zingarelli

Johns Hopkins Medical Institutions

erin.zingarelli@gmail.com

Publication Date: 20130726

DDx

This 49 year old man presented to the hospital with confusion and strange behavior. MRI showed an encephalitis, which was later determined to be caused by HSV.

  1. Which lobe of the brain was primarily affected?

    Left frontal lobe
    Incorrect - at this level, the frontal lobe is not visible.
    Right temporal lobe
    Incorrect. The pathology on this scan is left-sided.
    Left temporal lobe
    Correct! HSV encephalitis classically affects the temporal lobes.
    Right frontal lobe
    Incorrect - this patient has a left-sided encephalitis.
    Left parietal lobe
    Incorrect. Although you do not have another view to confirm location, know that HSV encephalitis is classically a temporal lobe phenomenon.

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