Herpes simplex encephalitis treated with acyclovir: diagnosis and long term outcome
| Autor: | N. M. McGrath, K F Powell, M C Croxson, Neil E Anderson |
|---|---|
| Rok vydání: | 1997 |
| Předmět: |
Adult
Male medicine.medical_specialty Pediatrics Adolescent viruses Acyclovir Neurological examination medicine.disease_cause Antiviral Agents Herpesviridae Central nervous system disease Olfaction Disorders Epilepsy Humans Medicine Encephalitis Viral Aciclovir Child Aged Neurologic Examination medicine.diagnostic_test business.industry Infant Electroencephalography Herpes Simplex Sequela Middle Aged medicine.disease Surgery Psychiatry and Mental health Herpes simplex virus Child Preschool DNA Viral Papers Female Neurology (clinical) business Encephalitis medicine.drug |
| Zdroj: | Journal of Neurology, Neurosurgery & Psychiatry. 63:321-326 |
| ISSN: | 0022-3050 |
| DOI: | 10.1136/jnnp.63.3.321 |
| Popis: | OBJECTIVES— The frequency and characteristics of the long term sequelae of herpes simplex encephalitis were assessed after treatment with acyclovir. METHODS—Patients were included if they were treated with acyclovir and the diagnosis of herpes simplex encephalitis was confirmed by culture of herpes simplex virus (HSV) from the brain, an increase in the CSF HSV antibody titre, or detection of HSV deoxyribonucleic acid in the CSF. Each patient's medical records were reviewed and surviving patients were interviewed and examined. RESULTS—A diagnosis of herpes simplex encephalitis was confirmed in 42 patients. Five patients (12%) died in the first month. Three patients (7%) had severe neurological sequelae and died after a longer interval. All but one of the 34 surviving patients had neurological symptoms, an abnormal neurological examination, or both. Twenty patients (48%) performed everyday activities as well as before herpes simplex encephalitis; nine patients (21%) were living independently, but were functioning at a lower level than before the illness; and five patients (12%) had a severe neurological deficit. Twenty nine of the 34 survivors were assessed six months to 11 years after herpes simplex encephalitis. The most common long term symptoms were memory impairment (69%), personality and behavioural abnormalities (45%), and epilepsy (24%). Short term memory impairment (70%), anosmia (65%), and dysphasia (41%) were the most common signs. CONCLUSIONS—Although acyclovir has reduced the mortality of herpes simplex encephalitis, 30% of this group of patients either died or had a severe neurological deficit. The other 70% of the patients regained independence in activities of daily living, but most of these people had persistent neurological symptoms, signs, or both. |
| Databáze: | OpenAIRE |
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