Figure 6. Viral rhombencephalitis in a 20-year-old woman who presented with headache, vertigo and photophobia and went on to develop left-sided paraesthesia and left facial weakness. (a,b) Axial plane T1 weighted SE images after iv gadolinium-DTPA. There is marked enhancement of the left trigeminal nerve (a) and nucleus (b). (c) Repeat examination after 4 months. Axial plane T1 weighted SE image after iv gadolinium-DTPA. The trigeminal nerve and nucleus now appear normal. Herpes simplex virus is the commonest cause of viral rhomboencephalitis, although often (as in this case) no specific pathogen can be isolated.
