A CASE OF TEMPORAL LOBE INTRACRANIAL SPACE OCCUPYING LESION MIMICKING AS HERPES SIMPLEX VIRAL ENCEPHALITIS
Prof. Omer Farooq, Dr. Irfan Gul* and Mudasir Ahmad Bhat
ABSTRACT
We report a case of 60-year-old man with intracranial space occupying lesion presenting as acute encephalitic illness. The patient presented with fever, abnormal behaviour and generalized tonic clonic seizures. Initial brain MRI showed left temporal lobe hyper intensity and Cerebrospinal fluid cytology revealed no cells with mild elevated protein. The patient had initially improved after medical treatment with a presumptive diagnosis of herpes simplex encephalitis (HSE). After 8weeks, the patient complained of recurrent seizures and altered sensorium. A follow- up brain neuroimaging (MRI) revealed marked increases in size and surrounding perilesional edema of the left temporal lesion on T2-weighted images and a new contrast-enhancing lesion on gadolinium -enhancedT1-weighted images. Stereotactic brain biopsy was planned.
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