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Herpes simplex encephalitis treated with acyclovir: diagnosis and long term outcome
N McGrath1, N E Anderson, M C Croxson
1Department of Neurology, Auckland Hospital, New Zealand.
Journal of Neurology, Neurosurgery, and Psychiatry
|November 5, 1997
Summary
Acyclovir reduces herpes simplex encephalitis mortality, but many survivors experience long-term neurological issues like memory loss and behavioral changes. Most regain independence but often with persistent symptoms.
Area of Science:
- Neurology
- Infectious Diseases
- Virology
Background:
- Herpes simplex encephalitis (HSE) is a severe neurological condition.
- Acyclovir is a primary treatment for HSE, impacting its outcomes.
Purpose of the Study:
- To assess the long-term neurological sequelae of herpes simplex encephalitis (HSE) in patients treated with acyclovir.
- To characterize the frequency and nature of these long-term effects.
Main Methods:
- Retrospective review of medical records for 42 confirmed HSE patients treated with acyclovir.
- Interviews and examinations of surviving patients to evaluate neurological status and functional outcomes.
Main Results:
- While acyclovir reduced mortality, 30% of patients died or had severe deficits.
- Of 34 survivors, 70% regained independence but most had persistent neurological symptoms or signs.
- Common long-term symptoms included memory impairment (69%), behavioral changes (45%), and epilepsy (24%).
Conclusions:
- Acyclovir significantly decreases HSE mortality but does not eliminate severe neurological deficits.
- Most survivors achieve independence in daily activities, yet often experience lasting neurological impairments.
- Long-term sequelae of HSE require ongoing management and support for affected individuals.