Herpes simplex encephalitis: Difference between revisions
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* Infection of the brain parenchyma by [[Herpes simplex virus|HSV]], with a predilection for temporal lobes |
* Infection of the brain parenchyma by [[Herpes simplex virus|HSV]], with a predilection for temporal lobes |
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= Presentation = |
== Presentation == |
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* Fever |
* Fever |
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* Rapidly progressing and can lead to coma |
* Rapidly progressing and can lead to coma |
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= Investigations = |
== Investigations == |
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* Imaging |
* Imaging |
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** Usually predominately over involved termporal lobe |
** Usually predominately over involved termporal lobe |
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= Management = |
== Management == |
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* Acyclovir 10mg/kg q8h IV for 14 days |
* Acyclovir 10mg/kg q8h IV for 14 days |
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Revision as of 10:30, 16 August 2019
- Infection of the brain parenchyma by HSV, with a predilection for temporal lobes
Presentation
- Fever
- Headache
- Altered level of consciousness
- Personality and behavioural changes
- Focal neuro deficits
- Seizures
- Rapidly progressing and can lead to coma
Investigations
- Imaging
- CT head usually normal
- MRI head can show T2 signal change in temporal lobes
- Lumbar puncture
- Elevated protein
- Lymphocytosis (10-1000 WBCs)
- Erythrocytes in 80% of cases ("hemorrhagic necrotizing meningoencephalitis")
- Normal or slightly low glucose
- HSV PCR is confirmatory
- EEG
- Spikes and slow waves over involved areas
- Periodic lateralized epiieptiform discharges (PLEDs)
- Usually predominately over involved termporal lobe
Management
- Acyclovir 10mg/kg q8h IV for 14 days
- Adjust for renal function
