Herpes simplex encephalitis

Herpes simplex encephalitis

Pathology:                    Herpes Simplex Virus (HSV)is a DNA virus.

Pathologically characterized by a necrotizingmicroencephalitis associated with oedema, haemorrhage, and encephalomalacia


Aetiology:                    HSV-1 is associated withorofacial infection

HSV-2 is associated withgenital infections.

Herpes simplex encephalitis should be strongly suspectedwhen there are focal features clinically or radiologically suggestive oftemporal lobe or orbitofrontal cortex involvement.


Symptoms:                   Headache, fever, personalitychanges, alteration of consciousness


Signs:                            Seizures, focal deficits such as dysphasia,hemiparesis, visual field defects, loss of sense of smell.


Investigations:          Imaging: MRI brain - Temporal/orbitofrontallobe high signal changes

Lumbar Puncture: Lymphocytosis withelevated protein and normal glucose

Viral PCR for HSVis usually positive

                                        EEG: Focalchanges in temporofrontal areas


Treatment:                  Medical IV acyclovir for14-21 days, antiepileptic drugs may be required


Complications:          Long term neurological sequelae suchas cognitive impairment and seizures


Prognosis:                    Early suspicion andcommencement of antiviral therapy is vital for good prognosis. If untreated,mortality can be as high as 70%. Complete recovery is only seen in a very smallpercentage of patients (2.5%).


Join Shiken For FREE

Gumbo Study Buddy

Explore More Subject Explanations

Try Shiken Premium
for Free

14-day free trial. Cancel anytime.
Get Started
The first 14 days are on us
96% of learners report x2 faster learning
Free hands-on onboarding & support
Cancel Anytime