Herpes encephalitis is a brain inflammation caused by herpes simplex virus, either type 1 (HSV-1) or type 2 (HSV-2). It is rather rare infection: there are about 2 cases per million people per year. According to the statistics, 10 percent of all encephalitis cases are caused by HSV in the United States. However, it is a very dangerous disease, and more than half of untreated cases of herpes encephalitis are fatal.
Causes and symptoms of the disease
Reactiveted HSV infection is the cause of the most cases of herpes encephalitis. The virus transmits from a peripheral site of the skin to the brain through a nerve axon. The reason of this transmission to the brain remains unclear. It is considered that changes or supression of the immune system may provoke this, as well as emotional or physical stress. People under 18 and above 50 years of age are affected more frequently.
The encephalitis itself is not transmitted, it is HSV that is transmitted through direct contact with infected person during the outbreaks.
Herpes encephalitis is a rapidly progressive disease. The symptomes of the first stage of the infection include headache, fever, and other flu-like symptoms such as muscle weakness or aches. These symptoms are rather confusing, that’s why is it difficult to reveal the disease at the early stages. These primary symptoms are followed by more severe, associated with brain and neurological damages, including:
- Severe headache, sometimes accompanied by stiff neck;
- Facial seizures;
- Nausea and vomiting;
- Paralysis or muscle weakness, usually affecting only one side of the body;
- Altered or decreased level of consciousness, ranging from drowsiness to coma;
- Loss of memory, forgetfulness, disorientation;
- Partial loss of hearing and vision, problems with speech;
- Changes in behavior and in personality, like irritability, aggression, anxiety and hostility;
- Brain damage may be seen in the frontal and temporal lobes, notably the electrical activity of the brain changes.
Encephalitis and newborns
In rare cases an infected mother may transmit the infection to the child during the delivery. Smptoms of the infection in newborns include lethargy, tremors and seizures.
Herpes encephalitis diagnosis and treatment
The disease is diagnosed by testing of the cerebrospinal fluid by a lumbar puncture. Increased number of white blood cells and protein is one of the signs of the infection.
The number-one treatment for herpes encephalitis is a high-dose of intravenous aciclovir. Patients with suspected infection should take aciclovir immediately, without waiting for the confirmation of the diagnosis, as any delay in treatment may be fatal. The recommended dosage of aciclovir is 10 mg per kg every 8 hours, the medicine is taken up to 2 weeks. Seizures should be treated with anticonvulsants and by administration of benzodiazepines. Analgesics like acetaminophen, ibuprofen are prescribed to reveal pain.
Due to the fact, that the causes of virus transmitting to the brain is poorly understood, there is no way to prevent herpes encephalitis once you have been infected with HSV. All the patients can do is to keep general recommendations for preventing further spread of the infection, like keeping hygienic rules, avoid touching infected skin and take antivirals.
As it was mentioned above, without treatment this disease often results in death and have severe consequences like neurological damages. That’s why you should visit your doctor as soon as you experience any of the above-mentioned symptoms. However, herpes encephalitis may be fatal or cause damages even if the treatment is taken. According to the statistics, only twenty percents of the patients recover with minor damages. The earlier the treatment starts, the higher the possibility of recovery.
These articles can be used for informational purposes only. To get an accurate diagnosis consult your doctor!
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