Herpes simplex encephalitis
—most common endemic encephalitis in the USA (2 per million) and causes 10-20% of all viral encephalitis.
—Early diagnosis is important because AV therapy can decrease mortality and morbidity.
—HSV1 causes 95% of HSE. Most commonly occurs due to virus reactivation. HSV2 causes 80-90% of neonatal encephalitis
Source: Panagaria A. Neurol In. 49:360; 2001.
§Definitive diagnosis: PCR, intrathecal antibodies, brain biopsy – take time and may be false negative in early disease .
§Imaging helps in establishing an early diagnosis.
source > Akyldz BN Paeditr Emerg Care 24;377 :2008.
— Usually bilateral
— Hemorrhage and enhancement seen
— Basal ganglia tend to be spared or involved in contiguity with the TL.
— Pons may be involved [Tien AJR:161,1993]
MR is more sensitive and shows lesions earlier than CT or SPECT,
Abnormal mri brain Of Herphes