Fig. 9.

A 42-year-old male with adult onset ornithine transcarbamylase deficiency who presented with acute confusional state. Restricted diffusivity (a) and increased FLAIR signal (b) in the temporal lobes, as well as increased T2 signal in insular and cingulate gyri (c, asterisks and arrowheads, respectively). Note symmetrical distribution and prominent cortical involvement, as opposed to Fig. 3, which shows Herpes encephalitis