PATIENT HISTORY :
This twenty-six year old, previously healthy nurse presented with a history of headaches starting in January of 1997 and new onset of seizures. MRI scans were abnormal (initial scans not available) and a clinical diagnosis of herpes simplex encephalitis was made. The patient was treated with two courses of acyclovir. An MRI scan in April 1997, following treatment, continued to show abnormal signal (see below). Follow up scan in June 1997 showed minimal progression, however, there appeared to be atrophy of the right temporal lobe. On July 18, the patient underwent stereotactic biopsy of the lesions after she complained of increasing left sided numbness over a three week period.