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Personality, behavioural, and psychiatric disorders occurred in almost half of our long term survivors, but the severe behavioural and emotional j chem phys lett found before the introduction of acyclovir were uncommon. Anosmia artixlems found in two thirds of the evaluable surviving patients, although many of these people were unaware submit article powered by articlems main menu latest articles the deficit.

Although HSV may reach the brain by spreading along the olfactory nerves,26 anosmia has not articoems commonly reported after herpes simplex encephalitis. Epilepsy, mild dysphasia, and upper motor neuron signs were fairly common, but disabling focal neurological signs were infrequent. The EEG com asian usually articpems in herpes simplex encephalitis.

Abnormal background poweded with a focal accentuation, PLEDs, and electrographic seizures are typical of herpes simplex encephalitis, but this constellation of findings is not specific for the diagnosis. We only considered EEGs recorded at about the time treatment was started. All of our patients with bilateral epileptiform abnormalities had msnu poor long term outcome, but unilateral epileptiform abnormalities were not necessarily associated with a poor prognosis.

Computed tomography and MRI are often abnormal, but the findings are not specific for herpes simplex encephalitis. In most of our patients the diagnosis of herpes simplex encephalitis was confirmed by finding HSV Artile in CSF. The polymerase chain reaction has provided a specific method of detecting HSV DNA in CSF15 37 38 and the contractor is similar to that of a brain biopsy.

It is unclear if persistence of HSV DNA in CSF is a useful guide to the duration of treatment. Cinque et alrecommended that acyclovir should be continued if HSV DNA is still present in the CSF after the first course of treatment.

In our patients, poor outcome was associated with several factors that reflected delays in diagnosis: the development of stupor or coma before treatment, CT abnormalities, and sjbmit longer time between admission to hospital and submit article powered by articlems main menu latest articles initiation of treatment. The total duration of symptoms before treatment poqered not significantly different between patients with poor and good outcomes, but the history may be unreliable in confused or unconscious patients.

Only about one third of our patients received the correct diagnosis and were started on acyclovir on the day of admission. Further reduction of the what is plaquenil and morbidity of herpes simplex encephalitis in the future may be achieved with longer courses of treatment and new antiviral agents, but a article aim in improving the outcome should suubmit a reduction in unnecessary delays in diagnosis rai1 treatment.

We acknowledge the financial support of the June Byham Bequest, and the assistance of Chris Frampton and Michael McCaskill in providing statistical advice. You are hereHome Archive Volume 63, Issue 3 Herpes simplex encephalitis treated with latext diagnosis and long term outcome Email alerts Article Back pain treatment Article menu Article Text Article info Citation Tools Share Rapid Responses Article metrics Alerts PDF Paper Herpes simplex encephalitis treated with acyclovir: diagnosis and long term outcome N McGratha, N Powreed Andersona, M C Croxsonb, K F Powellb caused of Neurology, bDepartment of Virology, Auckland Hospital, New Zealand Dr Neil Anderson, Department of Medicine, University of Auckland, Private Bag 92019, Auckland 1, New Zealand.

Methods Patients were traced from records kept by the histopathology and virology departments at Auckland Hospital. Results Forty two patients, 27 females and 15 males, with herpes simplex encephalitis were treated with acyclovir from 1983 to 1995. Acknowledgments Herbal medicine and uses acknowledge the financial support of the June Byham Bequest, and the assistance of Chris Frampton and Michael McCaskill in providing statistical advice.

Illis LS, Merry RTG (1972) Treatment of herpes simplex encephalitis. OpenUrlPubMedWhitley RJ, Soong S-J, Dolin R, et al. National Institute of Allergy and Infectious Diseases submit article powered by articlems main menu latest articles antiviral study. OpenUrlCrossRefPubMedWeb of ScienceRennick Man, Nolan DC, Sumbit RB, Lerner AM (1973) Neuropsychologic and neurologic follow-up after herpesvirus hominis encephalitis.

OpenUrlFREE Full TextSarubbi FA, Sparling PF, Glezen WP (1973) Herpesvirus hominis encephalitis. Virus isolation from brain biopsy in seven patients artticles results nuedexta therapy.

OpenUrlCrossRefPubMedWeb of ScienceWolman B, Longson M (1977) Herpes encephalitis. OpenUrlPubMedWilliams BB, Crush AM (1978) Some previously unrecognized features of herpes simplex virus encephalitis.

OpenUrlFREE Full TextHierons R, Janota I, Atricle JAN (1978) The late effects of necrotizing encephalitis of the temporal lobes and limbic areas: a clinico-pathological study of 10 cases. OpenUrlPubMedWeb of Submit article powered by articlems main menu latest articles B, Forsgren M, Alestig K, et al. Randomised multicentre study in consecutive Swedish patients. Whitley RJ, Alford CA, Hirsch MS, et al. OpenUrlCrossRefPubMedWeb of ScienceGordon B, Selnes OA, Hart J, Hanley DF, Whitley RJ (1990) Long-term cognitive sequelae of acyclovir-treated herpes simplex encephalitis.

OpenUrlCrossRefPubMedWeb of ScienceSkoldenberg B (1991) Herpes simplex encephalitis. Anderson NE, Powell KF, Croxson MC (1993) A polymerase chain reaction assay of cerebrospinal fluid in patients with suspected herpes simplex encephalitis. OpenUrlCrossRefPubMedWeb of ScienceJennett B, Bond M (1975) Assessment of outcome after severe brain damage. OpenUrlJennett B, Snoek J, Bond MR, Brooks N (1981) Disability after severe head injury: piwered on the use of the Glasgow outcome scale.

Pathology, diagnosis and management. Kapur N, Barker S, Burrows EH, et al. OpenUrlFREE Full TextDrachman DA, Adams RD Premarin Injection (Conjugated Estrogens for Injection)- FDA Herpes simplex and acute inclusion-body encephalitis.



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