Herpetic encephalitis
The content of the article:
- Causes and risk factors
- Forms of the disease
- Symptoms
- Diagnostics
- Treatment
- Possible complications and consequences
- Forecast
- Prevention
Herpetic encephalitis is a focal or diffuse inflammatory process that occurs in the structures of the brain and is caused by the herpes simplex virus. The disease can affect people of any age and gender, but is more common in people with weakened immunity and children in the first years of life. The incidence is 4-5 cases per 100,000 people.
The causative agent of herpetic encephalitis is the herpes simplex virus
Causes and risk factors
The causative agent of herpes encephalitis is the herpes simplex virus. It enters the human body from patients or virus carriers by airborne droplets (more often) or by household contact (less often). Through the mucous membrane of the oral cavity, the virus enters the axons of the olfactory nerves, and from there - directly into the central nervous system, where it is activated, causing inflammation.
In the pathological mechanism of the development of herpetic encephalitis, an important role is played by the state of the human immune system: weakened people are susceptible to disease. Factors that increase the risk of getting herpes encephalitis:
- age (elderly and infant);
- state of immunosuppression;
- the presence of any immunodeficiency conditions, both primary and secondary (including those caused by HIV infection).
Weakened immunity is the main factor that increases the risk of herpes encephalitis
Forms of the disease
Depending on the localization of inflammatory changes in the brain, the following forms of herpetic encephalitis are distinguished:
- polioencephalitis (gray matter structures are mainly affected);
- leukoencephalitis (white matter suffers more than others);
- panencephalitis (diffuse inflammation involving all cerebral structures).
Symptoms
Herpetic encephalitis begins acutely with a sudden rapid increase in body temperature to high values (39 ° C and above). Antipyretic drugs are ineffective. Jackson-type seizures occur at the height of the fever. They can cover both specific muscle groups and all skeletal muscles. Consciousness disturbances of varying severity are also noted - from slight disorientation to a coma.
Herpetic encephalitis begins with an increase in temperature to 39 degrees and above
Other symptoms of herpes encephalitis:
- the appearance of strabismus;
- visual impairment (double vision, veil before the eyes);
- short-term hallucinations;
- short-term amnesia;
- excessive sweating;
- violations of coordination of movements;
- monoparesis;
- disorder of speech function;
- mental and (or) motor excitement.
In infants, hydrocephalus or decortication of the brain may develop against the background of herpetic encephalitis.
Diagnostics
Diagnosis of herpes encephalitis is difficult. The disease requires differential diagnosis with a number of pathologies of the central nervous system, including viral encephalitis of a different etiology.
The most sensitive method of early diagnosis is the detection of herpes simplex virus DNA in the cerebrospinal fluid using polymerase chain reaction.
Serological methods are used for retrospective diagnosis. This is due to the fact that in the first days of the disease, the concentration of antibodies to the herpes simplex virus in the blood and cerebrospinal fluid is insignificant, it begins to increase only from the 7-10th day of the disease.
A brain biopsy allows you to carefully examine the tissue for the presence of the herpes virus
If necessary, a brain biopsy is performed, followed by histological, cytological, virological examination of the resulting tissue.
Treatment
Treatment of patients with herpetic encephalitis is carried out in the intensive care unit. This requirement is explained by the high risk of sudden development of acute respiratory failure.
Specific therapy for herpes encephalitis is carried out with the antiviral drug Acyclovir. Doses, frequency of administration, duration of treatment are determined in each case by the attending physician.
Patients with herpetic encephalitis are treated in the intensive care unit
To reduce the severity of the inflammatory process, the appointment of corticosteroids is indicated.
The treatment regimen for herpes encephalitis also includes immunomodulatory drugs and interferons.
Possible complications and consequences
Herpetic encephalitis often leads to the development of the following potentially life-threatening complications:
- swelling of the brain;
- compression of the brain;
- decortication of the brain;
- acute respiratory and cardiovascular failure.
In the long-term period after suffering herpetic encephalitis, the following can be observed:
- mental disorders;
- hearing loss;
- persistent neurological deficit;
- epilepsy.
Forecast
The prognosis for herpes encephalitis is serious. The mortality rate ranges from 20 to 80% and depends on the severity of the course of the disease, as well as the timing of the initiation of specific therapy.
Prevention
Prevention of the incidence of herpes encephalitis includes the following measures:
- refusal of close contact with people with obvious manifestations of herpes infection;
- after contact with a patient - treatment of skin and mucous membranes with an antiseptic solution;
- compulsory seeking medical help in the event of herpes sores;
- general strengthening of the body.
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Elena Minkina Doctor anesthesiologist-resuscitator About the author
Education: graduated from the Tashkent State Medical Institute, specializing in general medicine in 1991. Repeatedly passed refresher courses.
Work experience: anesthesiologist-resuscitator of the city maternity complex, resuscitator of the hemodialysis department.
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
