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Herpes Simplex Encephalitis

Overview

Herpes simplex encephalitis refers to a brain parenchyma infection caused by the herpes simplex virus. It leads to inflammation and swelling of the brain tissue and covering of the brain (meninges). If not treated promptly, it can cause life-threatening complications, making early recognition and treatment very important.

The symptoms of HSE may come on suddenly and progress rapidly. They include:

  • Fever
  • Headache
  • Altered sensorium (confusion, disorientation, coma)
  • Neck stiffness
  • Seizures
  • Weakness, nausea, vomiting

HSE is caused by infection with the herpes simplex virus (HSV). This is the same virus that causes oral or genital herpes but in rare cases, it can travel to the brain and cause encephalitis.

Doctors use several tests to confirm the diagnosis of HSE:

  • CSF examination: to determine pleocytosis (increased white cells suggesting infection)
  • MRI brain: to determine contrast enhancement in temporal areas, or vasculitic infarcts (small strokes)
  • EEG (electroencephalogram): to check periodic lateralised discharges (abnormal brain wave patterns).
  • Blood tests: for HIV antibodies or other underlying conditions

HSE is a medical emergency and needs immediate treatment:

  • Antiviral therapy (acyclovir): the most effective treatment to control infection
  • Supportive care: management of seizures, fluid replenishment, hydration, and caloric supplementation
  • ICU care: may be required for patients with severe illness, seizures, or coma

Seek urgent medical attention if you or someone you know experiences:

  • Sudden high fever with headache and confusion
  • Seizures with altered consciousness
  • Stiff neck with drowsiness or disorientation

There is no sure way to prevent HSE, but risks can be reduced by prompt treatment of herpes infections.

For diagnosis and management of Herpes simplex encephalitis, consult a Neurologist (specialist in brain and nerve disorders).

Disclaimer:

The information in this Health Library is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare professional with any questions about a medical condition or before starting any treatment. Use of this site and its content does not establish a doctor–patient relationship. In case of a medical emergency, call your local emergency number or visit the nearest emergency facility immediately.