HSV encephalitis

HSV Encephalitis HSV Encephalitis, or Herpes Simplex Virus Encephalitis, is a rare but serious condition characterized by inflammation of the brain due to infection with the herpes simplex virus. This condition can lead to significant neurological damage and requires prompt medical attention.

Etiology

HSV Encephalitis is most commonly caused by the herpes simplex virus type 1 (HSV-1), which is also responsible for cold sores. In rare cases, it can be caused by herpes simplex virus type 2 (HSV-2), which is more commonly associated with genital herpes. The virus can reach the brain through the trigeminal nerve or olfactory tract, leading to inflammation and damage.

Epidemiology

HSV Encephalitis is a rare disease, with an incidence of approximately 2-4 cases per million people per year. It can occur at any age but is most common in children and older adults. The condition does not have a seasonal pattern and can occur sporadically.

Clinical Presentation

Patients with HSV Encephalitis typically present with a rapid onset of symptoms, including:

• Fever
• Headache
• Altered mental status
• Seizures
• Focal neurological deficits

The temporal lobe is often affected, leading to symptoms such as memory disturbances and personality changes.

Diagnosis

The diagnosis of HSV Encephalitis is based on clinical suspicion and confirmed through laboratory tests. Key diagnostic tools include:

• Lumbar puncture: Analysis of cerebrospinal fluid (CSF) often shows elevated white blood cells, elevated protein, and normal glucose levels.
• Polymerase chain reaction (PCR): Detection of HSV DNA in the CSF is the gold standard for diagnosis.
• Magnetic resonance imaging (MRI): May show abnormalities in the temporal lobes.

Treatment

The mainstay of treatment for HSV Encephalitis is antiviral therapy. Acyclovir is the drug of choice and should be started as soon as the condition is suspected. Early treatment is crucial to reduce morbidity and mortality.

Prognosis

The prognosis of HSV Encephalitis varies. With prompt treatment, the mortality rate is reduced to around 20-30%. However, many survivors experience long-term neurological sequelae, such as cognitive impairment, seizures, and personality changes.

Prevention

There is no specific prevention for HSV Encephalitis. General measures include avoiding contact with individuals with active herpes lesions and managing recurrent herpes infections effectively.

See Also

• Herpes Simplex Virus
• Encephalitis
• Acyclovir
• Whitley, R. J., & Kimberlin, D. W. (2005). Herpes Simplex Encephalitis: Adolescents and Adults. Antiviral Research, 71(2-3), 141-148.
• Tyler, K. L. (2004). Herpes Simplex Virus Infections of the Central Nervous System: Encephalitis and Meningitis, Including Mollaret's. Herpes, 11(Suppl 2), 57A-64A.

NIH genetic and rare disease info

• NIH info on HSV encephalitis

HSV encephalitis is a rare disease.