Symptoms of herpetic encephalitis and methods of treating pathology

Most people (according to various sources, from 80 to 90%) are carriers of the herpes virus.

For the time being, the virus “sleeps” asymptomatically in the body. An unsuspecting carrier learns about the presence of herpes by discovering sores on the lips during a cold. At this time, immunity decreases, the body can hardly withstand the war against viruses on two fronts.

The disease is diagnosed all over the world, in people of all ages. Newborn children and elderly people with weakened immune systems are most susceptible to it.

The mechanism by which the virus passes into an inactive state is associated with its inhibition by the structures of the cells within which the virus settles. The body actively resists herpes. But when it weakens, under unfavorable circumstances, the disease can take over the body, ultimately leading to disability or death.

In this article, we will consider how herpetic encephalitis manifests itself, means of combating it, as well as methods of preventing the disease.

Clinical picture of herpetic encephalitis

Herpetic encephalitis is caused by the herpes simplex virus type 1 or 2. The difference between them is in the places of rashes on the mucous membranes. Type 1 is manifested by itchy blisters on the edges of the lips, type 2 - on the genitals. Depending on the type of virus, the rash may be localized on the genital mucosa.

A herpes rash soon goes away without a trace, just like a cold. It seems that the disease ends in complete recovery. However, this is not quite true. If the body has defeated ARVI, then it is almost impossible to get rid of the herpes virus, once it has entered the body.

But the problem is not that a person will continue to carry the virus inside the body asymptomatically. Herpes is waiting for the right moment to create problems. The biggest one is the possibility of contracting herpetic encephalitis, caused by the herpes simplex virus.

This dangerous brain disease can develop not only due to herpes. However, studies show that 20% of cases of diagnosed encephalitis are provoked by the herpes virus.

Causes of the disease and the patient’s age

The age factor greatly influences the manifestation of the disease. Even the infection mechanism itself is different.

In infants and young children, bilateral brain damage with neuronal dysfunction and damage to internal organs is detected.

In adult patients, the disease is associated with necrosis of brain tissue in the affected areas. Most often, such lesions are localized in the frontal and temporal lobes of the brain.

Children under one year of age and newborns are most often infected through the blood of their mother. This is possible during childbirth, when the baby passes through the birth canal. There are also cases of intrauterine infection during pregnancy. Children of preschool age and older catch the virus from their parents and other family members.

Infection at any age can occur during surgical operations or during injuries associated with damage to the skin. The cause of the disease in adults is often a previous outbreak of herpes simplex type 1 or 2.

Unlike adults, in children the virus rarely enters a latent (inactive) state. Symptoms of the disease appear immediately, and complications can develop just as quickly.

Provoking factors

The insidiousness of herpes is that its virus seems to wait for years for the right moment of weakening of the body in order to “stab in the back.” Viral reactivation usually occurs for the following reasons:

• Severe, frequent or prolonged stress.
• Previous acute viral or infectious disease, as well as the presence of chronic diseases.
• Immunodeficiency syndrome.
• Hormonal changes in the body.
• Alcoholism.

The risk group includes infants who do not have immunity to the herpes virus, and older people whose bodies are weakened compared to younger people. The vast majority of older people have a number of chronic diseases, making them especially vulnerable to infections.

Particular attention should be paid to children with stomatitis or gingivitis - diseases that can affect the brain through the trigeminal nerve and activate the herpesvirus at the site of the lesion.

Symptoms of herpetic encephalitis

In most cases, it is impossible to recognize the disease by rashes. With herpetic encephalitis, the structures of the brain are affected, but the usual symptoms of herpes simplex in the form of ulcers on the mucous membranes are usually absent.

However, other symptoms appear already in the first hours, subsequently constantly increasing.

Classic manifestations of herpetic encephalitis:

• blurred thinking, disorder of consciousness. Often the disease begins with deviations in behavior, confusion of thoughts, incoherent speech; in the future, as symptoms progress, it may result in falling into a coma;
• feverish condition. The temperature rapidly jumps to 39-40 degrees, and is not reduced by paracetamol or other well-known medications;
• convulsions; are expressed in “Jacksonian seizures” - a spasm starts from the foot of one leg, spreads to the entire leg, then moves to the other limb, and then starts all over again. It can also cover the torso, completely or partially; in severe cases, the intervals between attacks almost disappear (“Jacksonian march”).

Symptoms common to other types of encephalitis are possible: vomiting, increased sweating, taste and olfactory hallucinations.

There are atypical manifestations of the disease:

• pain in the legs, joints;
• short-term memory disorders;
• strabismus or double vision (due to damage to the oculomotor nerve);
• difficulty maintaining balance;
• monoparesis (motor pathology of one limb with extensive damage to the temporal lobe of the brain).

Acute and sluggish course

In the acute course of the disease, swelling of the brain occurs. The acute stage begins rapidly with headaches, and the patient's condition quickly deteriorates. Depression of consciousness is noted, which, if medical care is not provided, progresses to stupor and coma. With this scenario, respiratory arrest may occur.

Less commonly, the disease has a sluggish course. Its cause is chronic inflammation of the central nervous system.

For six months, the patient may only periodically increase body temperature, feel a loss of strength, and signs of asthenic syndrome. This form of herpetic encephalitis is more difficult to identify.

As a consequence, due to late diagnosis, treatment does not begin immediately, which leads to more frequent deaths of patients than in the acute form.

Diagnostics

An infectious disease specialist is involved in identifying and treating the disease. For diagnosis, you will need to take a general blood test, an important indicator of which is the level of ESR (erythrocyte sedimentation rate). With encephalitis, this indicator is higher than normal, sometimes many times.

CT (computed tomography) or MRI (magnetic resonance imaging) helps identify changes in brain tissue.

Treatment of herpetic encephalitis

The patient must be treated only in a hospital setting. The best solution would be to immediately call an ambulance. Being under constant medical supervision is necessary to save lives in emergency cases. Patients are placed in the hospital's intensive care unit and, if necessary, transferred to intensive care.

Drug therapy is the cornerstone of treatment. Usually patients are prescribed:

1. Antiviral agents (Acyclovir, Zovirax), which act on the herpes virus in infected cells; side effects may affect the kidneys.
2. Immunomodulating drugs (Interferon).
3. In some cases, immunoglobulin G.
4. Anticonvulsants, for example, Benzonal.
5. Drugs that improve blood microcirculation and metabolic processes (Trental and others).
6. Decongestants (Glycerol).
7. Glucocorticosteroids (Cortisone) may be used.

Herpes encephalitis is difficult for patients of any age.

Features of the course of herpes encephalitis in children

Many newborns who develop herpetic encephalitis die. This is due to the vulnerability of their body against the causative agent of the disease. Older children experience the disease very hard, often with complications and residual effects. Cases of recovery without consequences are known in adolescents.

Complications and consequences

More than half of patients experience encephalitis-related complications. These include:

• symptoms of acquired dementia, dementia (memory impairment);
• paresis of the limbs, other disorders of motor activity;
• Jacksonian type seizures;
• meningoencephalitis;
• epilepsy.

Both the course of the disease and its consequences depend on the area of ​​the brain that was affected by the virus. Residual effects can persist for a long time, affecting the patient’s quality of life.

Forecast

Herpetic encephalitis is a disease with a poor prognosis. Only a portion of patients are able to completely recover from it without complications. As a rule, this applies to adults and adolescents.

When falling into a coma, 85-90% of patients die. The mortality rate among newborns is even higher.

Children under 12 survive, but often remain disabled. As mentioned above, the prevalence of the herpes simplex virus in the world is extremely high. The best way to prevent it is to practice good personal hygiene. In this case, one should take into account the ability of the herpes virus to be in the environment, outside the human body, at temperatures up to 37-38 degrees Celsius. This suggests that you can become infected with the virus from an object that was used by a carrier of the virus, especially a person with manifestations of herpes. Such items can be lipstick, cutlery, drinking utensils, and linen. Anything that comes into contact with the sites of common herpes blisters (such as the lips) is a potential carrier of the virus.

The second means of preventing the disease is strengthening the body’s immune forces.

This is facilitated by hardening, a healthy lifestyle, good nutrition, adequate sleep, rest, exercise, moderate physical activity, and fresh air.

You need to try to minimize stress, develop stress tolerance and take care of your health constantly, and not just during exacerbations.

Source: https://onevrologii.ru/infektsionnye-zabolevaniya/gerpeticheskij-entsefalit-prichiny-diagnostika-lechenie

Symptoms and treatment of herpetic encephalitis in children and adults

Herpetic encephalitis is caused by the herpes virus types 1 and 2; in neurology, the disease is characterized as severe. To get rid of its acute manifestations, prevent the development of severe complications and reduce the risk of death, doctors carry out mandatory hospitalization of the patient.

The disease is characterized by an acute febrile onset with vivid symptoms. Its development may be preceded by an acute respiratory infection, which occurs at lightning speed.

Herpetic encephalitis is caused by herpes virus types 1 and 2.

What's happened

Herpes brain is a disease of viral etiology. The lesions are localized in the frontal and temporal lobes.

Herpetic pathology occurs with equal frequency in people of both sexes. The following groups of people are most susceptible to developing the disease:

1. From 2 to 30 years.
2. After 50 years.

Damage to the brain by herpetic infection is accompanied by inflammation (more details here).

The lesions are localized in the frontal and temporal lobes.

Acute stage

The onset of the acute stage of the disease is characterized by rapid brain swelling. In parallel, necrotic processes develop in the tissues of the lower region of the frontal lobes and the medial part of the temporal lobes.

The disease begins abruptly (with headaches) and progresses quickly. In the absence of medical care, the following are observed for several days:

1. Deterioration of the patient's condition.
2. A more severe course of the disease, manifested by increased symptoms.
3. Stupor (depression of consciousness, ability to function exclusively at the level of reflexes, numbness).
4. Coma.

In the absence of medical care, coma occurs for several days.

Without medical intervention, brain swelling increases. In more than 50% of cases, deep coma develops and breathing stops (on days 1-3).

Sluggish course of the disease

Some patients experience indolent herpes of the brain. Its development occurs due to chronic inflammation of the central nervous system, characterized by:

• asthenic syndrome;
• periodic increase in temperature.

External manifestations of encephalitis are observed only after six months.

The percentage of deaths resulting from the indolent form of the disease is higher than mortality due to the acute form. This is due to late diagnosis of the pathology and resistance of the virus to acyclovir.

The sluggish course of the disease is characterized by periodic increases in temperature.

Symptoms

There is a triad of first signs of the disease that are characteristic only of encephalitis caused by herpetic infection. They are observed in all patients without exception.

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Classic symptoms include:

1. Rapid increase in body temperature to 39°C.
2. The appearance of convulsions, disturbance of movements (can be observed both in the whole body and in its individual parts).
3. Disturbance of consciousness (ranges from confusion and oblivion to coma).

The classic symptom is the appearance of seizures.

The general clinical picture of herpetic brain disease in its acute form is similar to other types of encephalitis. Observed:

• disturbances in the functioning of the organs of vision, accompanied by double vision, strabismus;
• the occurrence of stiff neck muscles, drowsiness, vomiting and headaches;
• behavior changes;
• the appearance of hallucinations (olfactory and gustatory);
• increased sensitivity to light;
• memory and speech disorder;
• paralysis;
• instability while walking;
• increased sweating.

With herpetic brain disease, drowsiness is observed.

The appearance and severity of symptoms depend on the location of the herpetic lesion, its area, as well as the degree of tissue changes.

The sluggish form of the disease is characterized by:

• short-term convulsions;
• muscle dystonia;
• reflex asymmetry;
• one-sided paralysis.

Symptoms of low-grade encephalitis caused by herpes infection may be vague. This makes diagnosis difficult, increases the risk of complications, and increases the likelihood of death.

Symptoms of sluggish encephalitis may be vague - this increases the likelihood of death.

Causes

The pathogenic microorganism that causes inflammation enters the brain from the nasal cavity (transmitted along the branches of the nerves).

Encephalitis caused by the herpes simplex virus may not manifest itself for some time and remain dormant.

The risk group includes people who take drugs and abuse alcohol.

The risk group includes people who take drugs.

Treatment of herpetic encephalitis

If the development of encephalitis caused by a herpetic infection is confirmed, the person is hospitalized in the intensive care unit. Therapy is not carried out at home. This is due to the high likelihood of developing respiratory problems. Many patients require emergency ventilation.

The only treatment for the disease is drug therapy. To select the right drugs, the herpetic type of inflammation of the brain is differentiated from other diseases that have a similar clinical picture, and the degree of tissue damage is established.

Therapy is not carried out at home. This is due to the high likelihood of developing respiratory problems.

Diagnostics

Several examination methods help to recognize pathology and determine its severity. These include:

1. Magnetic resonance imaging. It is a key method for identifying affected areas of the brain, assessing the localization of herpetic lesions and monitoring the dynamics of the development of pathology. Allows differential diagnosis with other types of encephalitis, as well as ganglioglioma (neoplasm), sclerosis, hypoxic disorders, and epilepsy.
2. Electroencephalography. Helps to record the presence of characteristic periodic or semi-rhythmic bioelectrical activity in the brain. The presence of discharges indicates the development of encephalitis, which is of a herpetic nature.
3. Cerebrospinal fluid examination. Makes it possible to detect the DNA of the herpes virus and the presence of antibodies (10-12 days after the onset of the disease). The study is used to confirm the appropriateness of the prescribed treatment.
4. Biopsy of brain tissue. The analysis is performed if there is no result from treatment or it is impossible to make a diagnosis in another way.

What else to read: What to do if the lymph nodes are inflamed due to herpes

Drugs

When treating herpetic brain lesions, medications are used. They are divided into 3 groups:

1. Etiotropic (help eliminate the cause of the pathology). Acyclovir (Virolex, Zovirax) is used. It is administered intravenously. Immunostimulants are auxiliary medications. They enhance the immune response of cells, helping the body cope with herpes infection.
2. Pathogenetic (affects affected brain tissue). To relieve inflammation, glucocorticoids (Cortisone, Dexamethasone) are used. Decongestants (Glycerol, Mannitol) help reduce swelling. To improve blood microcirculation, angioprotectors and metabolic medications (Cavinton, Piracetam) are used.
3. Symptomatic (help eliminate external manifestations of pathology). Medicines used: antiparkinsonian (Parcopan), antipyretic (Paracetamol), anticonvulsant (Sibazon), improving the transmission of nerve impulses (Proserin).

Prevention

To prevent relapses, rehabilitation therapy is carried out. It helps restore normal brain function. To do this, the doctor prescribes:

• physiotherapeutic procedures;
• taking vitamins;
• massage;
• physical therapy.

To prevent relapses, rehabilitation therapy is carried out, one of them is physical therapy.

For prevention and quick recovery, experts recommend including in the diet a sufficient amount of macro- and microelements for the body.

Complications and consequences

The most severe consequence of herpetic brain disease is death. If you do not consult a doctor in a timely manner or the course of the disease is unfavorable, the patient may experience complications. These include:

1. Herpetic meningoencephalitis. It develops when the cerebral membranes are involved in the inflammatory process. Causes memory loss.
2. Partial or complete paralysis. Occurs when brain tissue becomes necrotic.
3. Jacksonian type seizures. Most cases occur on one side of the body. They start with the finger of the hand. They spread to the entire upper limb, leg, face. Accompanied by impaired consciousness. Repetition of attacks is observed at different intervals.
4. Epileptic seizures. They arise due to damage to the temporal lobe of the brain.
5. Loss of coordination.
6. The occurrence of auditory, visual, olfactory hallucinations.

If you do not consult a doctor in a timely manner or the course of the disease is unfavorable, the patient may experience visual hallucinations.

Many patients experience severe disorders of the nervous system (mental disorders, mental retardation, partial amnesia).

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Forecast

Herpes encephalitis is difficult to treat; in most cases, the course of the disease has an unfavorable prognosis. The mortality rate is:

• 20-25% of patients undergoing therapy;
• 70-75% of patients who did not treat the pathology.

Most survivors experience residual effects in the form of seizures or mental impairment.

Herpetic encephalitis in children

Herpes encephalitis can occur before birth. In this case, the infection penetrates the brain during pregnancy. In addition, in newborns the disease appears due to contact with carriers of the virus. The causative agent is the Epstein-Barr virus.

Signs of the presence of the disease are dysfunction of the brain. Convulsions, headaches, dysfunction of the digestive system, and coma occur. Often, before symptoms are detected in an infant, manifestations are diagnosed in carriers of the virus who have been in contact with the infant, infected adults.

If the disease is the result of a previous inflammatory process, the symptoms may resemble ARVI.

Treatment of herpetic encephalitis should begin immediately.

If this is not done, the consequences can be severe: damage to other organs is possible, in some cases the disease ends in death. Therapy is carried out with antiviral drugs.

In addition, medications that strengthen the immune system are used. In some cases, it is necessary to connect the child to a ventilator.

Source: https://gerpes.expert/oslozhneniya-i-posledstviya/gerpeticheskij-encefalit

What is herpetic encephalitis: how it manifests itself and is treated

Herpetic encephalitis is a common complication of recurrent HSV-1 viral infection; in neurology, the pathology is classified as severe. In most cases, hospitalization is required to relieve acute symptoms and prevent death.

Herpes brain is more common between 2 and 30 years of age and in people over 50 years of age.

What's happened

Herpes brain is more common between 2 and 30 years of age and in people over 50 years of age. The pathology is similar to acute encephalitis. The disease is caused by the herpes simplex virus and affects the brain.

The pathogen penetrates from the nasal mucosa through the olfactory neurons. When an infection takes hold, the brain becomes inflamed and characteristic swelling occurs.

Acute stage

For some time, the herpetic type of brain damage does not manifest itself in any way. The virus concentrates in the nervous tissue and is activated when the body's defenses are greatly reduced.

The acute stage manifests itself in a severe course, which can lead to coma.

In rare cases, necrosis of brain tissue occurs, which provokes irreversible consequences.

Sluggish course of the disease

Herpetic encephalitis can be sluggish, without significant manifestations. At the same time, many people do not suspect that they have a dangerous pathology, but simply refer to a temporary illness. This type of disease is typical for people whose immune system produces enough antibodies to fight the infection.

Symptoms

The first signs of the herpetic form of brain damage:

• increase in body temperature to +39…+40°C;
• impaired movement, feeling of numbness in the limbs;
• confusion;
• hallucinations;
• impaired perception of taste and smell;
• memory loss;
• behavioral changes, including psychosis;
• convulsive seizures.

Atypical forms of the lesion often have blurred symptoms, and acute mental disorders occur that were absent previously.

Herpetic encephalitis affects the gray matter of the brain, which leads to serious consequences.

Additional signs:

• the appearance of blisters on the skin and mucous membranes;
• severe headache, which is a consequence of swelling;
• hearing loss;
• tachycardia;
• increased blood pressure;
• deterioration of speech.

With herpetic brain damage, the ESR in the blood increases sharply.

Causes

The disease is easily transmitted; HSV-1 enters the body through mucous membranes or blood. For a long time, the viral infection does not manifest itself in any way. Hypothermia and severe illnesses that affect the immune system can provoke an exacerbation.

The disease is easily transmitted; HSV-1 enters the body through mucous membranes or blood.

Brain swelling caused by the herpes simplex virus occurs only in individuals with weakened body defenses. There is a high risk of developing such a dangerous complication in HIV-infected people. Additional reasons:

• severe influenza;
• severe stress and emotional overload;
• the presence of foci of chronic infections in the body;
• taking immunosuppressants;
• postoperative period;
• heavy physical activity;
• poor nutrition and sleep;
• presence of cytomegalovirus;
• skull injuries.

With herpetic brain damage, the ESR in the blood increases sharply.

In drug addicts and alcohol abusers, the risk of developing herpetic lesions of the meninges increases several times.

Treatment of herpetic encephalitis

Treatment methods include urgent hospitalization of the patient. Therapy is not carried out at home. In most cases, the person requires resuscitation. The traditional method of treatment is the administration of an antiviral drug in large doses. Acyclovir is first injected and then taken orally.

Therapy directed against herpetic brain damage is supplemented with glucocorticoids, which reduce the severity of swelling and pain.

Urgent ventilation and the use of diuretics often become necessary.

Diagnostics

It is important to differentiate this type of encephalitis from similar ones, since the symptoms are identical. Diagnostic methods to recognize herpetic brain damage:

1. PCR studies of cerebrospinal fluid. In this case, the DNA of the virus is determined; only this method makes it possible to make an accurate diagnosis.
2. Electroencephalography. This method involves the use of special equipment that allows you to record the bioelectrical activity of the brain.
3. Magnetic resonance imaging. It is the most reliable method of research, although it does not help differentiate herpetic lesions from other types of encephalitis. However, it allows us to identify the severity of the disease.

The disease is dangerous for newborns and can result in death.

Additionally, a general blood test is performed, which shows the degree of damage. Conclusions about the nature of the pathological process can be made based on ESR and leukocyte levels.

Drugs

To treat herpetic encephalitis, drugs from the antiviral group are used: Acyclovir, Zovirax, Virolex, etc.

After stabilizing the patient's condition, the patient takes the line of drugs orally. The dose is gradually reduced.

Prevention

Relapse prevention is important because... it is aimed at strengthening the immune system. For these purposes, a person takes antiviral drugs and vitamins for a long time. Additionally, for the prevention of herpetic encephalitis, a diet that includes a sufficient amount of useful micro- and macroelements is indicated.

Exercise therapy alternates with contrasting douches, which harden the body and increase its defenses.

The traditional method of treatment is the administration of an antiviral drug in large doses. Acyclovir is first injected and then taken orally.

Complications and consequences

The most common consequences of the disease:

1. Jacksonian type seizures are most often unilateral. Cramps begin with the finger, gradually covering the entire limb, moving to the leg and face. A disturbance of consciousness occurs. Subsequently, the symptoms progress, with repeated attacks occurring at different intervals.
2. Damage to the temporal lobe. Prolonged dizziness and epileptic seizures occur. The person may experience hallucinations. Herpetic meningoencephalitis can further provoke periodic memory loss, the patient ceases to recognize his family and friends.
3. Disorders of the nervous system manifest themselves in the form of loss of coordination of movements, pathological changes in the organs of hearing, vision and smell.
4. Necrosis of brain tissue can lead to partial paralysis, depending on the location of the area of ​​cell death.
5. Severe mental disorders are accompanied by both depression and neurosis. Permanent personality disorders may be present.
6. Mental retardation. The person loses the ability to think and analyze clearly. This condition is often accompanied by decreased memory.
   

   Even timely treatment does not provide a 100% guarantee that there will be no serious consequences affecting the central nervous system.

The disease can be fatal.

Forecast

Herpes encephalitis is difficult to cure. In most cases, the prognosis is unfavorable. Even timely treatment does not provide a 100% guarantee that there will be no serious consequences affecting the central nervous system.

The likelihood of mortality in herpetic encephalitis is high, even with the administration of large doses of antiviral drugs.

This is due to compression due to swelling of the tissues of the respiratory center, as well as the area that controls the activity of the heart.

In adults

In adults, herpetic brain damage occurs in a severe form and often provokes the development of seizures and severe pain.

To prevent herpetic encephalitis, a diet is indicated that includes a sufficient amount of useful micro- and macroelements and vitamin intake.

Herpetic encephalitis in children

The disease is dangerous for newborns and can result in death.

At the first signs of pathology in a child, urgent hospitalization is necessary.

With normal functioning of the immune system, the symptoms of herpetic encephalitis are often erased; the disease can be identified by disturbances in perception, hearing and vision.

Source: https://oherpese.ru/zabolevaniya/gerpeticheskiy-entsefalit

Herpetic encephalitis: symptoms, treatment, prevention

Many people are sure that the herpes virus is quite harmless and can only cause cosmetic defects on the lips. Meanwhile, after entering the human body, the infection remains in a “dormant” state for a long time.

Under certain circumstances, it can provoke a life-threatening disease such as herpetic encephalitis. In this case, a severe disruption in the activity of the central nervous system will occur - a condition that requires complex specialized treatment. Therefore, delaying consultation with a doctor is not recommended.

Causes and mechanism of pathology

Herpetic encephalitis is characterized by airborne transmission - viral particles from a sick person enter the body of healthy people through the oral mucosa. The causative agent in most cases of encephalitis is the herpes simplex virus, the first subtype of HSV-1.

Experts have two theories about how infectious agents travel to the human brain. Firstly, after penetrating the tissues and bloodstream, microorganisms penetrate the autonomic ganglia of the spinal cord roots, where they can hide for some time, and under the influence of provoking factors become more active and provoke encephalitis.

And, secondly, the herpetic infection enters the fibers of the nervous system in a latent state, and only later does inflammation of the membranes of the brain occur - encephalitis.

Provoking factors:

• decrease in the body's defenses - a state of immunodeficiency;
• frequent exacerbations of chronic diseases that undermine the immune system;
• hard physical labor;
• hypothermia - local or general;
• more promiscuous sexual intercourse;
• traumatic brain injuries.

Sometimes specialists are unable to establish the exact circumstances of the occurrence of such a disease.

The main symptoms of the pathology

As a rule, herpes encephalitis of the brain begins acutely - literally in a few hours or one day, the infection completely affects all structures of the central nervous system. The pathology is especially difficult in children.

Against the background of a sharp rise in body temperature - up to 40 degrees and above, the patient experiences a characteristic triad of encephalitis:

• cramps - can affect the entire body or a separate muscle group;
• consciousness - impaired from short-term episodes of disorientation in space to severe coma;
• fever - chills, increasing weakness, drenching sweat.

In addition to the above clinical manifestations, other symptoms may be observed with herpetic encephalitis:

• appetite is significantly reduced - up to its complete loss;
• headache – intense, increasing, unresponsive to analgesics;
• violation of the functional activity of the oculomotor nerve - strabismus, double vision of objects before the eyes;
• hallucinations – short-term or long-lasting, vivid;
• sweating - after the temperature decreases, patients literally “bathe” in their own sweat;
• memory - individual episodes of life during the acute period of encephalitis are completely erased;
• speech – impaired, slurred;
• failure in the vestibular apparatus - a person with herpetic lesions of the brain loses the ability to control voluntary movements of the limbs;
• paresis/paralysis in one half of the body - herpes agents led to inflammation of the temporal lobe of the cerebral cortex;
• sleep disturbance.

In its typical course, herpetic encephalitis does not cause diagnostic difficulties for specialists. However, in some cases, laboratory and instrumental diagnostics help put everything in its place.

Symptoms of the disease in children

With primary herpetic encephalitis, the incubation period in children can be 2–26 days, but on average it takes 9–14 days. In most cases, its appearance is preceded by a child suffering from severe ARVI or stomatitis of a herpetic nature.

A sharp rise in temperature with the simultaneous appearance of seizures will indicate a deterioration in the baby’s well-being. Typical herpes blisters can be observed on the skin and mucous membranes. Brain damage, encephalitis, will be indicated by:

• severe headache - in the occipital, temporal parts, gradually intensifying, becoming widespread;
• vomiting – frequent, without relief of the patient’s condition;
• consciousness – disrupted by episodes of confusion, up to coma;
• lack of full orientation in space and time.

Swelling of brain tissue due to inflammation is also indicated by convulsions - periodic twitching in the feet and hands, turning into paroxysmal contractions of the limbs on one half of the body.

In children, the disease can be complicated by mental disorders, loss of skills, epilepsy, paresis and paralysis. Without timely medical care, respiratory and cardiovascular activity stops. The lethal outcome in early childhood from the herpes form of encephalitis reaches 65–80%.

Diagnostics

Inflammation of the meninges with different types of pathogens has a similar clinical picture. However, to accelerate the positive effect of treatment measures, it is necessary to establish the true cause of the development of encephalitis.

For this purpose, cerebrospinal fluid is taken to conduct a specific study - determining the DNA of the virus. Only this analysis allows you to quickly determine the true culprit of the disease. In herpes encephalitis, it is the herpes simplex virus.

To confirm pathological foci in brain structures, instrumental examination methods are used:

• electroencephalography – registers bioelectric impulses of the cerebral cortex;
• computer or magnetic resonance imaging - determining the severity of encephalitis.

A specialist will make a full diagnosis of herpetic encephalitis based on a combination of information from laboratory and instrumental examinations, as well as the patient’s complaints and examination.

Treatment tactics

If a person is suspected of having herpetic encephalitis, he should be immediately sent to the hospital, since the risk of a rapid deterioration in consciousness, even to the point of coma, is extremely high already in the first day from the moment of infection of the brain tissue.

Before establishing the herpes nature of the pathogen, the patient is given symptomatic measures:

• drugs to reduce fever;
• medications to reduce intracranial pressure and relieve swelling of brain tissue;
• means for boosting immunity - immunomodulators.

However, herpetic encephalitis requires complex treatment, which is based on antiviral drugs - Acyclovir, Virolex, Zovirax.

In the first 1-2 days they are administered parenterally - injections or droppers, then in tablet form - for another 10-14 days.

The optimal doses of medications are selected by the doctor individually , taking into account the patient’s age, weight, and severity of the disease.

At the same time, they continue to take corticosteroids, immunomodulators, antipyretics, anticonvulsants, and neuroprotectors. The key to success in the fight against encephalitis is the use of modern, multicomponent treatment regimens. This allows you to reduce the likelihood of deaths to 20–25%.

Complications and consequences

Acute herpetic encephalitis in adult patients, and especially in young children, is the basis for a number of complications:

• paresis/paralysis of the limbs - varying degrees of severity;
• personality disorders - a person can change beyond recognition;
• mental retardation – a decrease in intellectual capabilities, which is manifested by partial or complete loss of professional skills;
• mental disorders - a tendency to depression, neuroses;
• pathological changes in the sensory organs - vision, hearing.

In some cases, the acute form of herpetic encephalitis becomes chronic, with episodes of exacerbation of inflammatory symptoms. At the same time, there is a high risk of complications: multiple sclerosis, dementia - even dementia, Alzheimer's disease, schizophrenia, parkinsonism syndrome.

In order to reduce the risk of the above consequences and complications of encephalitis, doctors take measures during the recovery stage after an infection.

Prevention

Even Paracelsus and Hippocrates were firmly convinced that it is much easier to prevent any disease than to treat it later. A similar statement is also relevant in relation to herpetic encephalitis.

Preventive measures are correctly aimed at strengthening the body’s defenses:

• timely vaccination against influenza, herpes;
• lack of contact with already sick people, especially during the seasonal rise in infections;
• when the first signs of infection appear, stay at home, call a doctor, follow all his recommendations;
• eat right – include more vegetables and various fruits in your diet;
• avoid stress;
• get enough sleep;
• walk more in the fresh air;
• harden.

By following the above recommendations, the human immune system will remain strong, capable of coping with any infection, even one as dangerous as herpetic encephalitis. Then the disease will be mild, without any complications, and recovery will come much faster.

Source: https://nevrology.net/sindromy-i-zabolevaniya/infektsionnye/gerpeticheskij-entsefalit.html

Herpetic encephalitis: causes, symptoms, treatment

More than 80% of the world's population is infected with the herpes simplex virus, but in the body of most people it lies dormant and is activated only during periods of decreased immunity.

Herpetic infection primarily affects the mucous membranes of the eyes, lips, external genitalia and skin, and at first glance seems quite harmless, since it is relatively easy to treat, but in particularly severe cases of the disease, it can disrupt the functioning of the central nervous system and cause the development of encephalitis.

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Herpetic encephalitis is an acute infectious lesion of the brain that is caused by the herpes simplex virus.

If we talk about its consequences, they include death and dementia - acquired dementia, expressed in the loss of previously acquired knowledge and difficulty acquiring new ones.

Etiology and mechanism of disease development

Herpes simplex virus

As already mentioned, herpes simplex encephalitis is caused by the herpes simplex virus (usually the first type - HSV-1), which enters the human body by airborne droplets (less often - household) mainly through the oral mucosa and enters the central nervous system through the axons of the olfactory neurons .

The pathogenesis of the disease is not fully understood, but scientists have two theories of its development.

The first theory is based on the fact that the herpes virus enters the autonomic ganglia, where it undergoes a reactivation process and spreads throughout all fibers of the nervous system, and the second assumes that the herpes infection enters the fibers of the central nervous system in a latent state and is already there (under the influence of various factors ) is reactivated.

Clinical picture of herpetic encephalitis

Herpetic encephalitis most often affects the temporal and frontal lobe of the brain, where foci of necrosis with hemorrhagic lesions are found. Symptoms of the disease can manifest themselves differently and depend on which part of the brain is most affected, but scientists identify a characteristic triad of herpetic inflammation, which includes:

• acute fever - a sharp increase in body temperature to 39 degrees (the temperature does not fall even after taking antipyretics);
• Jacksonian type convulsions - can affect the entire body or a specific area;
• disturbance of consciousness - from short-term forgetting to deep coma (the consequences of this disorder are most often disappointing, because in 90% of cases a person who falls into a coma does not survive).

The above-described symptoms of the development of the disease occur in all patients without exception, but there are also signs of encephalitis, the manifestation of which will be strictly individual. These include:

• disorders of the oculomotor nerve (patients complain of strabismus, double vision);
• short-term hallucinations (may indicate the development of other central nervous system diseases, but require immediate treatment, since their consequences can be unpredictable);
• increased sweating;
• short-term amnesia;
• dysfunction of the vestibular apparatus (inability to control the movements of your body when walking);
• monoparesis or impaired movement in the limbs of one half of the body (this symptom indicates that the infection mostly affects the temporal lobe of the brain);
• excitation;
• speech disorders.

In addition, encephalitis caused by herpes infection can be suspected by symptoms such as increased protein in the cerebrospinal fluid, high erythrocyte sedimentation rate and lymphopenia. Infants sometimes develop decortication of the brain or hydrocephalus.

Diagnostics

Diagnosis of herpetic encephalitis

The main methods for diagnosing the disease include magnetic resonance imaging of the brain and biopsy. Also, when making a diagnosis, doctors use data from a blood test on the erythrocyte sedimentation rate and a biochemical study of the cerebrospinal fluid, where the DNA of the herpes simplex virus should be detected.

Basic treatment methods

Treatment of herpetic encephalitis must be started immediately, because in its absence, 80% of patients quickly fall into a coma and die, therefore, timely identified symptoms of infection give a person a chance to live.

Sometimes the disease develops at lightning speed and is accompanied by rapid swelling of the brain and subsequent cessation of breathing, and if the person still survives, the symptoms develop in the opposite direction, but persistent residual effects remain.

In rare cases (1–2% of all patients), a person recovers without consequences.

Treatment of herpetic brain damage takes place in a hospital setting, because the risk of sudden respiratory arrest is very high, and doctors begin drug therapy even without confirming the diagnosis with laboratory tests.

The patient is prescribed Acyclovir (in high doses and intravenously) as the main drug, and additional therapy includes the use of antibiotics that can penetrate the blood-brain barrier, immunomodulatory agents (Interferon), and drugs for symptomatic treatment (antipyretics, anticonvulsants, neuroprotectors).

The drug Acyclovir

Herpetic encephalitis is a dangerous disease, the lack of treatment of which can lead to irreversible consequences, therefore, at the first symptoms of its development, you must consult a doctor.

Today, scientists are working on creating a universal antiherpetic vaccine, but its effectiveness has not yet been sufficiently studied.

The only available method of preventing the development of encephalitis is the regular use of medications that improve the functioning of the immune system.

Source: https://SimptoMer.ru/bolezni/infektsii-parazity/639-gerpeticheskiy-entsefalit-simptomy