Encephalitis means infection of the brain by viruses. Viruses are microbes like bacteria and are contagious. Viruses, which have a different structure than bacteria, cannot be destroyed by antibiotics. The most common symptoms of encephalitis are headache accompanied by fever, nausea, vomiting, and confusion (confusion in place, time, and person information). As the disease progresses, neurological losses, epileptic seizures and paralysis may occur.
Herpes viruses are the main causes of encephalitis. The most feared of these is herpes simlpex type I. Many viruses other than herpes can also cause encephalitis. The most important step in diagnosing encephalitis is the evaluation of the patient's complaints and neurological findings. This is followed by brain imaging, preferably drug-enhanced brain MRI. Examination of cerebrospinal fluid (cerebral fluid) is often necessary for a definitive diagnosis.
The main target in the treatment of encephalitis is the treatment of herpes virus. The reason for this is that we do not have antivirals that are sufficiently effective against other viruses, and that viruses other than herpes do not often cause permanent neurological losses. Intravenous treatment should be given in the presence or suspicion of herpes virus infection.
Herpes simplex virus (HSV) is an enveloped virus containing double-stranded DNA and infections are common among humans. Two strains have been identified, HSV-1 and HSV-2. Both these strains of HSV primarily infect the skin, mucous membranes, eye, central nervous system (CNS), and genital organs; It may also cause systemic disease. HSV-1 infects the skin and mucosa, and HSV-2 infects newborns through the genital organs and the mother's genital tract
HSV Encephalitis
CNS caused by HSV is a disease that can have a fatal course. It is an infectious disease.
It is the most common cause of acute sporadic viral encephalitis.
The mortality rate without treatment is high. Early diagnosis and treatment is important. Its annual incidence is 2–3 per million. 95% of herpes encephalitis cases are HSV-subtype 1.
More than two-thirds of HSV-1-related infections develop as a result of reactivation of endogenous latent HSV-1 in individuals previously exposed to the virus; The remaining infections occurred in individuals who had not been previously exposed to HSV. It develops as a result of primary infection in later years.
Viruses enter the body through the oropharyngeal mucosa, conjunctiva and damaged skin.
DIAGNOSIS
EEG and imaging are in the diagnosis. There is no pathognomonic EEG pattern in co- HSE.
Cranial MRI-CT
Focal hemorrhagic necrosis occurs characteristically in the temporal lobe in HSV encephalitis. This feature is a distinctive finding from other encephalitis.
The mortality rate in HSV Encephalitis varies between 0-10%.
The most common neurological sequelae are neuropsychological disorder, behavior-language. disorder, focal motor deficit and/or epilepsy.
In cases presenting with fever, impaired consciousness, and neurological deficit, HSV encephalitis should be considered and treatment should be started without delay. Thus, both mortality and morbidity will decrease.
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