Herpes simplex encephalitis: A review

Herpes Simplex Type 1 Encephalitis

“…The most common cause of acute sporadic viral encephalitis (95% cases) is Herpes Simplex Type-1 and it causes fatal encephalitis. The incidence of HSE is reported as 2-4/1 million/year (Johnson, 1998;Koskiniemi et al, 2001;Levitz, 1998;Rantalaiho et al, 2001). All over the world, irrespective of the seasons, encephalitis occurs sporadically in all ages and does not show gender difference throughout the year (Whitley et al, 1982).…”

“…In several studies, it was observed that the disease had a more severe course in immunecompetent patients. Because, the CNS disorders are estimated to occur as a result of serious contributions of immune-mediated mechanisms (Hudson et al, 1991;Levitz, 1998;.…”

“…Despite extensive researches in animal models, pathogenesis of HSE is not fully explained. 3 different hypotheses have been proposed in formation of the HSE via HSV type-1 (Levitz, 1998;Schmutzhard, 2001;. According to examinations conducted by National Institute of Allergy and Infectious Diseases (NIAID) and Common Antiviral Study Group (CASG), the primary infection has been reported to occur in about one-third of patients with HSE.…”

“…Only 10% of the patients had a medical history of recurrent herpes labialis (Nahmias et al, 1982). Also in 1/3 of the HSE cases, reactivation of existing latent viruses in CNS, such as brain stem and cerebellum, plays role (Levitz, 1998;Rock. & Frasher, 1983;.…”

“…Acyclovir should be applied intravenously every 8 hours at 10 mg / kg dose slowly (over 1 hour). The duration of treatment should be at least 14 days, but 21 days will be better (Djukic et al, 2003;Levitz, 1998). Because worsening of the disease was defined in short-term treatment with reactivation of the virus (Baringer & Pisani, 1994;Van Landingham et al, 1988).…”