The authors describe specific MRI features that suggest the diagnosis of va
ricella tester encephalitis. MRI initially revealed discrete, subcortical,
nonenhancing lesions that coalesced and developed enhancement. Gray matter
involvement was seen later. Autopsy revealed spherical lesions of demyelina
tion and hemorrhagic cavitation confirmed. as varicella tester encephalitis
. Characteristic MR features may suggest the diagnosis of varicella tester
encephalitis, enabling definitive diagnostic testing and early institution
of antiviral treatment.