Malingering or expected deficits? A case of herpes simplex encephalitis

This study describes a patient with herpes simplex encephalitis. Brain MRI showed the expected finding of medial temporal damage. Neuropsychological assessment results were consistent with the location of damage, with profound memory impairment and mildly impaired naming, but normal visuospatial and executive skills. The patient also showed a typical testing pattern of insufficient effort and possible malingering, which was concerning as she was seeking disability compensation. In spite of this, we chose to place greatest weight on the finding of deficits consistent with the type, location, and severity of brain damage, considering this to be true cognitive impairment.