Neuroimaging: herpes simplex encephalitis: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Radiology · Neuroimaging: herpes simplex encephalitis

Sample item

A patient with fever, seizures and altered behaviour has MRI showing T2 hyperintensity and swelling of the medial temporal lobes and insula bilaterally, with relative sparing of the basal ganglia. What is the likely diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Herpes simplex encephalitis

HSV encephalitis typically affects the limbic system: medial temporal lobes, insula and inferior frontal lobes, often asymmetrically, and spares the basal ganglia. Japanese encephalitis targets the thalami, basal ganglia and midbrain. Treatment with intravenous aciclovir is started empirically.

Option by option

  • A. Herpes simplex encephalitis (correct)

    Correct. Temporal lobe and insular involvement sparing basal ganglia suggests HSV.

  • B. Neurocysticercosis

    Neurocysticercosis shows cysts with scolices.

  • C. Tuberculous meningitis

    TB meningitis shows basal meningeal enhancement and hydrocephalus.

  • D. Japanese encephalitis

    Japanese encephalitis involves the thalami and basal ganglia.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Radiology questions

Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is A, Herpes simplex encephalitis. HSV encephalitis typically affects the limbic system: medial temporal lobes, insula and inferior frontal lobes, often asymmetrically, and spares the basal ganglia.

Why is "Neurocysticercosis" not the answer?

Neurocysticercosis shows cysts with scolices.

Why is "Tuberculous meningitis" not the answer?

TB meningitis shows basal meningeal enhancement and hydrocephalus.

Why is "Japanese encephalitis" not the answer?

Japanese encephalitis involves the thalami and basal ganglia.

What concept does this question test?

It tests Neuroimaging: herpes simplex encephalitis in Radiology. Japanese encephalitis targets the thalami, basal ganglia and midbrain. Treatment with intravenous aciclovir is started empirically.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Neuroimaging: herpes simplex encephalitis?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.