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A clinico-pathological study of herpes simplex encephalitis.

P G Kennedy1, J H Adams, D I Graham

  • 1Glasgow University, Department of Neurology.

Neuropathology and Applied Neurobiology
|September 1, 1988
PubMed
Summary

Herpes simplex virus encephalitis (HSE) is a severe brain infection. Early diagnosis and treatment with intravenous acyclovir improved survival rates in patients with this condition.

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Area of Science:

  • Neurology
  • Virology
  • Pathology

Background:

  • Herpes simplex virus encephalitis (HSE) is a rare but serious neurological condition.
  • Accurate diagnosis and effective treatment are crucial for patient outcomes.
  • This study analyzes clinical and pathological findings of HSE cases over a 13-year period.

Purpose of the Study:

  • To review clinical presentations and pathological findings in 24 cases of HSE.
  • To evaluate diagnostic methods including viral isolation, histology, immunofluorescence, and in situ hybridization.
  • To assess the impact of intravenous acyclovir treatment on patient prognosis.

Main Methods:

  • Retrospective analysis of 24 HSE cases diagnosed between 1972 and 1985.
  • Diagnosis confirmed by herpes simplex virus (HSV) isolation or characteristic histological changes in brain tissue.

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  • Clinical data, diagnostic test results, and treatment outcomes were reviewed.

    • Main Results:

    • Common clinical presentations included influenza-like illness, headache, confusion, meningism, coma, aphasia, and focal neurological signs.
    • Mortality was high (58%), but survival (42%) was associated with intravenous acyclovir treatment.
    • Cerebral biopsy was effective for diagnosis, with HSV isolation and histological confirmation in most cases.

    Conclusions:

    • HSE presents with diverse neurological symptoms and has a significant mortality rate.
    • Intravenous acyclovir is associated with improved prognosis.
    • Advanced techniques like immunocytochemistry and in situ hybridization confirm productive HSV infection in brain cells.