Snapshot A 38-year-old man is brought to the emergency department by his brother due to "abnormal behavior." The brother reports that the patient has been constantly putting objects in his mouth. The patient has also made sexually inappropriate remarks to his sister-in-law. The patient's brother believes that the patient is depressed since he did not show any emotion after his mother's death. The brother denies he had any head trauma but does recall that approximately 3 months ago he was hospitalized for herpes encephalitis that was treated late. Introduction Clinical syndrome neurologic syndrome that results from bilateral destruction of the temporal lobes Etiology temporal lobe lesions secondary to a wide array of causes, such as trauma infarction malignancy degeneration (e.g., Alzheimer's disease) infection inflammatory process it is especially important to recognized that herpes simplex encephalitis (HSE) can be a cause HSE responds to acyclovir treatment Presentation Symptoms cardinal symptom is hyperorality impulsiveness placidity hypersexuality amnesia aphasia