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Non-herpes simplex encephalitis is early exclusion of herpes simplex etiology possible?

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Summary

Since effective antiviral treatment is available for herpes simplex encephalitis (HSE), early diagnosis or exclusion of herpes simplex etiology is essential for prognosis. In a retrospective study of 25 cases of acute viral encephalitis not caused by herpes simplex virus (non-HSE), we investigated whether HSE can be excluded in the early phase before serological evidence is present. Using clinical means, history, investigations of CSF (protein, cells), EEG, and CCT, HSE could not be excluded with reliability. This is because clinical signs and laboratory results are not pathognomonic for any form of viral encephalitis, even if periodic activity in EEG and temporal attenuation in CCT are more frequent in HSE than in other forms of encephalitis. Therefore, in all cases of severe encephalitis, acyclovir therapy should be initiated early.

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References

  1. Barocka A (1980) Akute virale Meningoencephalitiden. Neurol Psychiatr 6:300–302

    Google Scholar 

  2. Booss J, Esiri MM (1986) Viral encephalitis. Blackwell, Oxford

    Google Scholar 

  3. Cheesbrough JS, Finch RG, Ward MJ (1985) A case of herpes zoster associated encephalitis with rapid response to acyclovir. Postgrad Med J 61:145–146

    Google Scholar 

  4. Christe W, Kölmel HW (1985) Die Behandlung des Zoster mit Aciclovir. Klinikarzt 14:1451–1452

    Google Scholar 

  5. Elian M (1975) Herpes simplex encephalitis, prognosis and long-term follow-up. Arch Neurol 32:39–43

    Google Scholar 

  6. Felgenhauer K (1982) Differentiation of the humoral immune response in inflammatory diseases of the central nervous system. J Neurol 228:223–237

    Google Scholar 

  7. Felgenhauer K, Ackermann R (1985) Early diagnosis and treatment of herpes simplex encephalitis. J Neurol 232:123–124

    Google Scholar 

  8. Finke E, Ackermann R, Felgenhauer K (1982) Symptomarme Herpes-simplex-Enzephalitis. Dtsch Med Wochenschr 107:1020–1023

    Google Scholar 

  9. Flügel KA (1983) Prognose der Enzephalitiden und Meningitiden. Lebensversicherungsmedizin VII:161–165

    Google Scholar 

  10. Greenberg DA, Weinkle DJ, Aminoff MJ (1982) Periodic EEG complexes in infectious mononucleosis encephalitis. J Neurol Neurosurg Psychiatry 45:648–651

    Google Scholar 

  11. Griffith JF, Chien LT (1983) Herpes simplex virus encephalitis. Med Clin North Am 67:991–1008

    Google Scholar 

  12. Hacke W, Zeumer H (1986) Herpes-simplex-Enzephalitis. Dtsch Med Wochenschr 111:23–25

    Google Scholar 

  13. Hilgenstock F (1975) Zur Klinik der akuten Virusenzephalitiden. Fortschr Neurol Psychiatr 43:81–97

    Google Scholar 

  14. Ikemura Y, Akena H, Okada A (1984) Postinfektiöse Röteln-Encephalitis. Nervenarzt 55:83–85

    Google Scholar 

  15. Illis LJ, Taylor FM (1972) The electroencephalogram in herpes simplex encephalitis. Lancet I:718–722

    Google Scholar 

  16. Kaschka WP, Kaschka-Dierich CH (1984) Herpes-simplex-Enzephalitis. Dtsch Med Wochenschr 109:1000–1004

    Google Scholar 

  17. Kaschka WP, Kaschka-Dierich CH (1985) Diagnostische Möglichkeiten bei viralen Meningoencephalitiden. Therapiewoche 35:573–581

    Google Scholar 

  18. Kennard C, Swash M (1981) Acute viral encephalitis its diagnosis and outcome. Brain 104:129–148

    Google Scholar 

  19. Mapper PE, Cleator GM, Logson M (1984) Mild forms of herpes encephalitis. J Neurol Neurosurg Pschiatry 47:1247–1250

    Google Scholar 

  20. Lethinen I, Halonen JP (1984) EEG findings in tick-bourne encephalitis. J Neurol Neurosurg Psychiatry 47:500–504

    Google Scholar 

  21. Möller A, Ackermann R, Felgenhauer K, Ulm H (1982) Zoster-Enzenhalitis ohne Exanthem. Dtsch Med Wochenschr 107:882–825

    Google Scholar 

  22. Poburski R, Malin JP (1984) Rötelnencephalitis bei einer Erwachsenen mit ungewöhnlichem Verlauf. Dtsch Med Wochenschr 109:1796–1800

    Google Scholar 

  23. Pourmand R, Marchand ON, Cook JA (1984) Perodic lateralized EEG abnormality in a case of Neuro-Bechet syndrome. Clinical Electroencephalogr 15:122–124

    Google Scholar 

  24. Prange H, Wissmann H, Ritter G (1982) Schwere Virusencephalitiden: Therapie mit Interferon. In: Mertens HG, Dommasch D (eds) Enzephalitis. Perimed, Erlangen

    Google Scholar 

  25. Schear HE (1984) Periodic EEG activity. Clin Electroencephalogr 15:32–39

    Google Scholar 

  26. Schlageter N, Jubelt B, Vick NA (1984) Herpes simplex encephalitis without CSF leukocytosis. Arch Neurol 41:1007–1008

    Google Scholar 

  27. Schorre W (1979) Die Infektionskrankheiten des Nervensystems. Urban und Schwarzenberg, München

    Google Scholar 

  28. Sköldenberg B, Alestig K, Burman L, Forkman A, Lövgren K, Norrby R, Hiernstedt G, Forsgren M, Bergström T, Dahlqvist E, Fryden A, Norlin K, Olding-Stenkvist E, Uhnoo J, de Vahl K Acyclovir versus vidarabine in herpes simplex encephalitis. Lancet II: 707–711

  29. Sköldenberg B, Forsgren M, Alestig K, Fryden A, Norlin K, Norby R, Olding-Stenkvist E (1985) Design of therapeutic studies in herpes simplex encephalitis. Letter to the editor. Lancet I:285

    Google Scholar 

  30. Swash M (1984) Management of acute viral encephalitis. Br J Hosp Med 25:250–255

    Google Scholar 

  31. Todman DH (1983) Encephalitis in infectious mononucleosis. Clin Exp Neurology 19:81–86

    Google Scholar 

  32. Upton A, Gumpert J (1970) Electroencephalography in diagnosis of herpes simplex encephalitis. Lancet I:650–652

    Google Scholar 

  33. Wees SJ, Madhavan T (1980) Herpes zoster encephalitis: successful therapy with vidarabine. Henry Ford Hosp Med J 28:67–70

    Google Scholar 

  34. Whitley RJ, Soong SJ, Dolin R, Galasso GJ, Chien LT, Alford CA, and the NIAID Collaborative Antiviral Study Group (1977) Adenine arabinoside therapy of biopsy-proved herpes simplex encephalitis. N Engl J Med 297:289–294

    Google Scholar 

  35. Whitley RJ, Soong SJ, Hirsch MS, Karchmer AW, Dolin R, Galasso G, Dunnick JK, Charles AA, and the NIAID Collaborative Antiviral Study Group (1981) Herpes simplex encephalitis. Vidarabine therapy and diagnostic problems. N Engl J Med 304:313–318

    Google Scholar 

  36. Whitley RJ, Soong SJ, Linneman C, Lin C, Pazin G, Alford CA (1982) Herpes-simplex-encephalitis. JAMA 247:317–320

    Google Scholar 

  37. Whitley RJ, Soong SJ, Alford CA, Hirsch MS, Schooley R, Oxman MN, Connor JD, Betts R, Dolin R, Reichman RC (1985) Design of therapeutic studies in herpes simplex encephalitis. Lancet I:284–285

    Google Scholar 

  38. Whitley RJ, Alford CA, Hirsch MS, Schooley RT, Luby JP, Aoki FY, Hanley D, Nahmias AJ, Soong SJ, and the NIAID Collaborative Antiviral Study Group (1986) Vidarabine versus acyclovir therapy in herpes simplex encephalitis. N Engl J Med 314:144–149

    Google Scholar 

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Authors and Affiliations

  1. Abteilung für Neurologie der Rheinischen Landesklinik Bonn, Kaiser-Karl-Ring 20, D-5300, Bonn 1

    V. Schuchardt

  2. Abteilung für Neurologie der Medizinischen Fakultät der Rheinisch-Westfälischen Technischen Hochschule Aachen, D-5100, Aachen, Germany

    H. Buchner

Authors
  1. V. Schuchardt
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  2. H. Buchner
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Schuchardt, V., Buchner, H. Non-herpes simplex encephalitis is early exclusion of herpes simplex etiology possible?. Eur Arch Psychiatr Neurol Sci 236, 372–378 (1987). https://doi.org/10.1007/BF00377428

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  • DOI: https://doi.org/10.1007/BF00377428

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