Neurology Book

http://www.fpnotebook.com/

HSV EncephalitisAka: Herpes Simplex Encephalitis

Advertisement

  1. See Also
    1. Encephalitis
  2. Epidemiology
    1. Most common cause of sporadic focal Encephalitis
  3. Etiology
    1. Adults
      1. Herpes Simplex Virus Type I
      2. Herpes Simplex Virus Type II (rare)
    2. Neonates
      1. Perinatal Herpes Simplex Virus Type II transmission
  4. Pathophysiology
    1. Destructive lesions by HSV infection
      1. Inferior Frontal Lobe
      2. Anterior Temporal Lobe
  5. Labs
    1. CSF Culture
      1. Generally not useful
  6. Diagnosis
    1. CT Head or MRI Head imaging
      1. Characteristic frontal and Temporal Lobe involvement
    2. Electroencephalogram (EEG)
      1. Periodic sharp wave activity temporally
      2. Background of focal or diffuse slowing
    3. Brain biopsy
      1. Gold standard for diagnosis
  7. Management
    1. Acyclovir
      1. Dose: 10-12.5 mg/kg IV every 8 hours for 10-14 days
      2. Directions: Give dose over 60 minutes
      3. Start early to maximize best possible outcome
      4. Start empirically
  8. Complications
    1. Dementia
    2. Personality Disorder
    3. Memory loss
    4. Aphasia
  9. Prognosis
    1. Mortality: 10-40%
    2. High risk of severe residual neurologic deficit

Herpes encephalitis (C0276226)

Definition (MSH)An acute (or rarely chronic) inflammatory process of the brain caused by SIMPLEXVIRUS infections which may be fatal. The majority of infections are caused by human herpesvirus 1 (HERPESVIRUS 1, HUMAN) and less often by human herpesvirus 2 (HERPESVIRUS 2, HUMAN). Clinical manifestations include FEVER; HEADACHE; SEIZURES; HALLUCINATIONS; behavioral alterations; APHASIA; hemiparesis; and COMA. Pathologically, the condition is marked by a hemorrhagic necrosis involving the medial and inferior TEMPORAL LOBE and orbital regions of the FRONTAL LOBE. (From Adams et al., Principles of Neurology, 6th ed, pp751-4)
ConceptsDisease or Syndrome (T047)
ICD9054.3
MSHD020803
EnglishENCEPH HERPES SIMPLEX, HEMMORRHAGIC ENCEPHALITIS, HERPES ENCEPH, Herpes encephalitis, HERPES SIMPLEX ENCEPH, Herpes Simplex Encephalitides, Herpes Simplex Encephalitis, HERPETIC ENCEPH, Herpetic Encephalitides, HERPETIC ENCEPHALITIS, HSE - Herpes simplex encephalitis, STRUMPELL-LEICHTENSTERN ENCEPHALITIS
Spanishencefalitis herpetica
Parent ConceptsHerpesviridae Infections (C0019372), Viral Encephalitis (C0243010), Herpes Simplex Infections (C0019348), Herpes virus infection of the central nervous system (C1320193), Ambiguous concept (C1274012), Duplicate concept (C1274013)
SourcesDXP, MSH, MTH, MTHICD9, NDFRT, QMR, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



Navigation Tree