Diagnostic and therapeutic studies in herpes simplex encephalitis [HSE]

ABSTRACT

Twenty children [aged 14 years] with suspected HSE are studied. Main clinical presentations were fever, focal seizures altered state of consciousness and focal neurologic deficits. C.S.F. examination was normal in three cases and abnormal in 17 [85%]; with pleocytosis, increased protein concentration and excess R.B.Cs. Serologic studies revealed elevation of antiherpes antibodies in C.S.F. in 4 cases [20%] and in serum in 7 cases [35%]. CT. examination was normal in 15 patients, and abnormal in 5 cases [25%] showing reduced enhancement [hypodense area] in temporal lobe [s]. E.E.G. was abnormal in all patients, it revealed Periodic Lateralized Epileptiform Distharge [P.L.E.D] in 17 cases and other patterns denoting encephalopathy and periodic epileptiform activity in the rest. All patients received specific antiviral antiherpes drug [Acyclovir], in a 10 days course. Complete recovery occur in 12 cases, 6 patients survived with some residue and 2 patients dieded. Validity of newer tools of investigations is discussed