HSV encephalitis is the most common cause of fatal encephalitis in the United States. Patients will usually present with altered consciousness, mentation, focal CN deficits, seizures, and other neurologic deficits, along with fever. T2 weighted MRI will usually reveal a unilateral increase in signal intensity in the temporal region, with cingulate and insulate gyri often involved. In fact this combination of findings, cingulate & temporal region edema, is the discriminatory factor which makes this appearance classic for HSV encephalitis. The involvement of two different blood supplies, the ACA supplying the cingulate gyrus, and the MCA supplying the frontotemporal region, makes a vascular etiology less likely, leaving an inflammatory etiology to be the most likely cause. Most literature regarding HSV encephalitis cite the common findings listed above in most MRI studies: unilateral gyral swelling of the cingulate, insula, and temporal lobe.