Herpes Simplex Encephalitis

Herpes Simplex Encephalitis General Information

Herpes Simplex Encephalitis is known to be a very serious medical condition that occurs in people who are no younger than 25 years old. The risk of developing it increases with the age group. In the young adults, this disorder will result in a primary infection while in the older persons it will reactivate latent infections. There are several different names that doctors use when they refer to this illness, for example: HSE, sporadic fatal encephalitis or viral encephalitis. This disease seems to be caused by a retrograde transmission of a virus from a peripheral site (that is generally found on the face) to the CNS (central nervous system), through the nerves’ axons. It is well known that the virus responsible with the occurrence of Herpes Simplex Encephalitis can be found in the Gasser’s ganglion of the fifth (trigeminal) cranial nerve. Studies showed that the virus targets the brain’s temporal lobes but the reason for this action is yet unknown. If this medical condition is not discovered and treated properly in due time, it usually results in rapid death in more than 60% of the cases. Although nowadays the treatment options are more complex and advanced, 15% of the Herpes Simplex Encephalitis cases have a fatal end despite the best modern treatment that they have benefited from. Unfortunately, even if there are survivors of this serious illness, they may suffer from long term neurological problems caused by the disease. There is no known predilection for race and it is known that both men and women have equal chances of developing it.

Herpes Simplex Encephalitis Symptoms

General and focal signs of cerebral dysfunctions may be caused by the medical condition known as Herpes Simplex Encephalitis. This is an acute and sporadic illness that occurs without following a seasonal pattern. There are no specific signs and symptoms of HSE. This is why, if the examination is not done carefully and correctly, no pathognomonic findings help distinguishing Herpes Simplex Encephalitis from other neurological diseases with similar signs and symptoms, such as brain abscesses, non-HSV encephalitis or tumor. The few several signs and symptoms that we can precise and are suggestive for diagnosing Herpes Simplex Encephalitis are: headaches, vomiting, confusion, abnormal CSF findings, fever, seizures, memory loss, changes in the normal behavior (along with other psychiatric symptoms) and focal neurological findings (focal weakness). After a physical examination, some other typical findings will be revealed, for example: dysphasia, visual field loss, hemiparesis, pepilledema, ataxia, cranial nerve defects and problems with the consciousness. If the proper treatment is not applied in time because the medical condition was discovered late, the complications (aggravations) of the patient’s health state are similar to those of all seriously ill persons who have depressed levels of consciousness: decubiti, aspiration or deep venous thromboses. In these cases, the mortality and morbidity rates are really high. In individuals who do not benefit from a proper treatment, the rate of mortality is of about 60% in comparison with the values of patients who benefited from a therapy that are significantly low (the rate in this case is around 15 %).

Herpes Simplex Encephalitis Treatment

Herpes Simplex Encephalitis or HSE is a serious medical condition that has significant and worrying morbidity and death rates. Although over the past two decades specialists have managed to improve the therapy methods used against this disease (thus, the antiviral therapies have become really advanced), this viral disorder does more and more victims all over the world. It is highly important to keep yourself informed in what concerns this medical disorder and to talk to your health care provider about the treatment options that offer the best effects. If you complain of any of the signs and symptoms specific for this illness, go as soon as possible to your health care provider because only he or she can advise you what to do or can recommend you to consult with other specialists in this domain. The patient will often be sent to a specialist in infectious diseases or to a neurologist because they can determine better and faster HSE and can provide him more appropriate treatment options. Also, the prehospital care of a patient suffering from Herpes Simplex Encephalitis is extremely important.

The ABC’s of medical help must be assured to the patient and this consists of supportive management of the individual’s airways, breathing and circulation systems. Once arriving to the emergency department care, the medical professional will make sure that the patient has been diagnosed correctly. A patient is suspected to be suffering from Herpes Simplex Encephalitis is considered especially if he or she presents fever, focal neurological problems, progressively deterioration of consciousness levels or abnormal findings of the CSF (cerebrospinal fluid) that are not determined by other causes. The tests for Herpes Simplex Encephalitis must be carefully done. Usually, the health care providers order analysis of the cerebrospinal fluid (CSF) and serologic analysis. The serologic or CSF evaluations are important for retrospective diagnosis. The CSF analysis show in patients who suffer from this medical condition mononuclear pleocystosis of 20-300 WBCs/µL. Important when doing this test are the levels of proteins (between 50 and 500 mg/dL) and glucose (that may be mildly decreased or even normal with values between 20 and 50 mg/dL). There are a few patients, especially small children (about 3-15% of the cases) who will have normal results after their initial CSF testing. However, after several examinations, these results may reveal low levels of proteins and cell counts. Another reliable test is the electroencephalography also known as EEG that will show focal abnormalities. Once the diagnosis is established, the doctor can proceed with expeditious evaluations. The therapy with Acyclovir must be rapidly initiated being very crucial in reducing the morbidity and mortality rates and because the expectations of untreated Herpes Simplex Encephalitis are really poor. The main drugs of choice in treating this medical condition are the antiviral agents. Acyclovir will determine a series of in vivo reactions after which this substance will be transformed into acyclovir triphosphate, a potent inhibitor that helps the viral replications occur. This drug has very few side effects and it is usually administrated intravenously IV.