Herpes Virus Encephalitis in Adults: Current Knowledge and Old Myths

Alejandro Rabinstein

doi:10.1016/j.ncl.2017.06.006

Herpes Virus Encephalitis in Adults: Current Knowledge and Old Myths

Alejandro Rabinstein

Neurology

Research output: Contribution to journal › Review article › peer-review

19 Scopus citations

Abstract

Herpes simplex virus (HSV) encephalitis is uncommon in clinical practice, but is frequently suspected in patients with acute alterations of consciousness. Symptoms and physical signs are nonspecific, and diagnostic confirmation typically hinges on demonstration of viral DNA in cerebrospinal fluid. Brain MRI is helpful in diagnosis and provides prognostic information. Early initiation of intravenous acyclovir is essential to optimize the patient's chances of favorable recovery. HSV encephalitis can trigger an autoimmune reaction with the possible appearance of antibodies to neuronal surface antigens. Thus, recrudescence of neurologic impairment after a treated episode of HSV encephalitis warrants consideration of secondary autoimmune encephalitis.

Original language	English (US)
Pages (from-to)	695-705
Number of pages	11
Journal	Neurologic Clinics
Volume	35
Issue number	4
DOIs	https://doi.org/10.1016/j.ncl.2017.06.006
State	Published - Nov 1 2017

Keywords

Diagnosis
Encephalitis
Herpes simplex virus
HSV
Prognosis
Treatment

ASJC Scopus subject areas

Clinical Neurology

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10.1016/j.ncl.2017.06.006

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abstract = "Herpes simplex virus (HSV) encephalitis is uncommon in clinical practice, but is frequently suspected in patients with acute alterations of consciousness. Symptoms and physical signs are nonspecific, and diagnostic confirmation typically hinges on demonstration of viral DNA in cerebrospinal fluid. Brain MRI is helpful in diagnosis and provides prognostic information. Early initiation of intravenous acyclovir is essential to optimize the patient's chances of favorable recovery. HSV encephalitis can trigger an autoimmune reaction with the possible appearance of antibodies to neuronal surface antigens. Thus, recrudescence of neurologic impairment after a treated episode of HSV encephalitis warrants consideration of secondary autoimmune encephalitis.",

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AB - Herpes simplex virus (HSV) encephalitis is uncommon in clinical practice, but is frequently suspected in patients with acute alterations of consciousness. Symptoms and physical signs are nonspecific, and diagnostic confirmation typically hinges on demonstration of viral DNA in cerebrospinal fluid. Brain MRI is helpful in diagnosis and provides prognostic information. Early initiation of intravenous acyclovir is essential to optimize the patient's chances of favorable recovery. HSV encephalitis can trigger an autoimmune reaction with the possible appearance of antibodies to neuronal surface antigens. Thus, recrudescence of neurologic impairment after a treated episode of HSV encephalitis warrants consideration of secondary autoimmune encephalitis.

KW - Diagnosis

KW - Encephalitis

KW - Herpes simplex virus

KW - HSV

KW - Prognosis

KW - Treatment

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Herpes Virus Encephalitis in Adults: Current Knowledge and Old Myths

Abstract

Keywords

ASJC Scopus subject areas

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