MRI for a female patient aged 41 who presented in a state of disturbed conscious level which preceded days before by fever, headache, hallucinations, behavior changes and weakness of lower limbs.
What is the diagnosis?
 
It is a case of "Herpes Encephalitis". Note the obvious temporal lobe involvement.
 
 
N.B. Herpes simplex encephalitis presents with nonspecific symptoms: a flu-like prodrome, followed by headache, fever, behavioral and speech disturbances, and focal or generalized seizures. The temporal lobe is often involved. Untreated disease and presentation with coma carry a high mortality rate, with many survivors suffering neurologic sequelae.