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Predictors of outcome in HSV encephalitis
Tarun D Singh1, Jennifer E Fugate1, Sara Hocker1
1Department of Neurology, Mayo Clinic, 200 First St. SW, Mayo W8B, Rochester, MN, 55905, USA.
Journal of Neurology
|November 17, 2015
Summary
Older age, coma, restricted diffusion on MRI, and delayed acyclovir treatment negatively impact outcomes for herpes simplex virus encephalitis (HSE) patients. Early intervention and supportive care are crucial for improving prognosis in HSE.
Area of Science:
- Neurology
- Infectious Diseases
- Radiology
Background:
- Herpes simplex virus encephalitis (HSE) is a severe neurological condition.
- Identifying prognostic factors is crucial for patient management.
Purpose of the Study:
- To analyze clinical features, radiological findings, and management of PCR-confirmed HSE.
- To identify factors influencing prognosis in HSE patients.
Main Methods:
- Retrospective review of 45 PCR-confirmed HSE cases (1995-2013).
- Univariate and multivariate analyses to determine factors associated with good (mRS 0-2) or poor (mRS 3-6) outcomes.
- Assessment at hospital discharge and 1-year follow-up.
Main Results:
- Most common MRI findings included temporal, insular, and frontal lobe involvement.
- HSV-1 MRI patterns were homogeneous; HSV-2 patterns were heterogeneous.
- Older age, coma, restricted diffusion on MRI, and delayed acyclovir treatment were associated with poor outcomes.
Conclusions:
- Older age, coma, restricted diffusion on MRI, and delayed acyclovir administration are predictors of poor outcomes in HSE.
- Seizures, focal deficits, and FLAIR/T2 abnormalities did not significantly impact functional outcome.
- Timely diagnosis and treatment are vital for improving HSE prognosis.
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