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Characteristic early electroencephalographic changes in herpes simplex encephalitis.

L T Ch'ien, R M Boehm, H Robinson

    Archives of Neurology
    |June 1, 1977
    PubMed
    Summary
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    Electroencephalograms (EEGs) may aid in diagnosing herpes simplex encephalitis (HSE). Specific periodic sharp waves on EEG suggest HSE, guiding early diagnosis and optimal brain biopsy sites.

    Area of Science:

    • Neurology
    • Virology
    • Diagnostic Imaging

    Background:

    • Herpes simplex encephalitis (HSE) is a severe CNS infection.
    • Early diagnosis of HSE is crucial for effective treatment.
    • Electroencephalography (EEG) is a common diagnostic tool for neurological disorders.

    Purpose of the Study:

    • To evaluate the diagnostic utility of EEG in patients with suspected HSE.
    • To identify specific EEG patterns associated with HSE.
    • To determine if EEG can guide brain biopsy in HSE diagnosis.

    Main Methods:

    • Review of EEGs from 17 patients with meningoencephalitis within seven days of symptom onset.
    • Patients were categorized into confirmed HSE (viral isolation) and non-HSE groups.
    • EEG findings were correlated with virological and histopathological data.

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    Main Results:

    • All patients exhibited abnormal EEGs with diffuse or focal slowing.
    • A distinctive EEG pattern of high-voltage, periodic sharp waves (1-3 Hz) from unilateral temporal lobes was observed in 3/5 confirmed HSE cases.
    • This specific EEG pattern was absent in non-HSE patients.
    • EEG abnormalities often corresponded to the site of maximal viral yield in brain biopsies.

    Conclusions:

    • Specific periodic sharp waves on EEG may be indicative of early HSE.
    • EEG can assist in differentiating HSE from other forms of meningoencephalitis.
    • EEG findings may help localize the optimal site for brain biopsy to maximize viral detection.