Question

Regarding herpes encephalitis, all are true EXCEPT:

• A. Focal symptoms common
• B. Temporal lobe involved
• C. MRI is diagnostic
• D. EEG not diagnostic

Hint:

EEG actually shows characteristic periodic temporal discharges, so that negative claim is the false one.

Answer 1

The Correct Option is D

Step 1: Read the stem as asking for the single incorrect statement about HSV-1 encephalitis. Confirm each true item first, then the odd one out is the answer.

Step 2: The virus has a predilection for the medial temporal and inferior frontal lobes. This anatomical targeting explains the frequent focal deficits, so the focal symptoms and temporal lobe statements are both accurate.

Step 3: On neuroimaging, MRI outperforms CT by detecting early temporal lobe hyperintensity and is the investigation of choice, so calling MRI diagnostic is correct.

Step 4: Electroencephalography is classically abnormal early, with periodic lateralized epileptiform discharges and temporal slowing that strongly point to the diagnosis. So saying the EEG is not diagnostic contradicts the textbook and is the false statement being sought.

\[\boxed{\text{EEG not diagnostic - this is the FALSE statement}}\]