If you are interested in learning about the herpes simplex encephalitis treatment, you have come to the site where you will receive the information you need on this subject in a clear, simple and understandable form by reading this article.
Although the word treatment refers to practices that are applied after the diagnosis of the disease, in this writing I have also included very useful information on prevention.
The article is structured in six parts and it has an index linking each part. You can start reading through any of the parts and return to the index to continue. I recommend you read the article from beginning to end because all its content is interesting and useful.
In the prevention part, I have included information about a treatment aimed at eliminating the virus that causes the disease, which you can access by clicking here.
|Click on the section you prefer to read|
|Encephalitis from herpes|
|Herpes encephalitis causes|
|Herpes encephalitis signs and symptoms|
|Herpes simplex encephalitis diagnosis|
|Herpetic encephalitis prevention|
|Herpes simplex encephalitis treatment|
Encephalitis from herpes [↑]
This section is dedicated to explaining the essence of herpes encephalitis, including the definition of the disease, the organ it affects, the affectations it produces, its incidence and prognosis.
The exposition begins by talking about the brain or encephalum, the organ from which the name of the disease comes.
The word brain leads us to think of the cerebrum, although it also refers to other organs protected by the skull: cerebellum, brain stem, thalamus and hypothalamus.
The brain and spinal cord make up the central nervous system (CNS).
The meninges also envelop and protect the spinal cord.
The name of the most external meninge is dura mater, the name of the intermediate is arachnoid mater and the name of the most internal is pia mater.
Between the arachnoid mater and the pia mater there is a space named the subarachnoid space. It contains a clear liquid named cerebrospinal fluid (CSF) that prevents the brain from hitting the bones of the skull when the head is moved.
The cerebrospinal fluid circulates throughout the central nervous system: brain and spinal cord. For this reason, a sample of this fluid is taken to diagnose infections.
The cerebrum is the largest structure in the brain. It is made up of two layers; the outer layer is called the cerebral cortex and its color is beige-pink, although it is known by the name of gray matter. The color of the inner layer is whitish.
In embryonic development, the growth of the cerebral cortex increases disproportionately with respect to the inner layer. For this reason it is folded into ridges and grooves.
The name of the cerebral ridges is gyrus; the deepest grooves are named fissures and the name of the shallowest grooves is sulcus.
The deepest fissure of the cerebrum is oriented from front to back; it is named a longitudinal fissure and divides the cerebrum into two parts: the right and left hemispheres.
These cerebral hemispheres are connected to each other by the corpus callosum: a structure of white nerve fibers that transmit information from one hemisphere to another.
On the surface of each hemisphere there are sulci that divide it into four parts which are named cerebral lobes.
The sulcus separating the frontal lobe from the parietal lobe is called Rolando’s sulcus or central sulcus; the sulcus separating the temporal lobe from the frontal and parietal lobes is called Silvio’s sulcus or lateral sulcus.
In addition to these four superficial external lobes, in each cerebral hemisphere there is an internal lobe, called the insula lobe. This lobe is located below the point at which Rolando’s sulcus meets Silvio’s sulcus.
What is encephalitis from herpes
There are several diseases that affect the brain and meninges. Encephalitis is inflammation and irritation of the brain.
Inflammation of the meninges is named meningitis1. Sometimes encephalitis and meningitis occur simultaneously; in such cases it is considered a single disease whose name is meningoencephalitis.
The cause of encephalitis and the characteristics of the patient who suffers from it are factors that influence its severity.
Although there are different types of viruses that cause encephalitis, the most serious cases of encephalitis in temperate countries are those caused by a herpes simplex virus. In these cases, the disease is named herpes encephalitis or herpetic encephalitis.
Sometimes the disease is named by one of the phrases: herpes simplex encephalitis or herpes simplex virus encephalitis with the intention of specifying the cause because there are other viruses in the herpes virus family that also cause encephalitis.
Herpes encephalitis starts in the cerebrum and the mechanism by which the virus infects it is not well known. Several hypotheses are used in this regard.
One hypothesis states the virus reaches the cerebrum through the bloodstream. Another hypothesis considers the virus accesses the cerebrum using the nerve axons.
The truth is the herpes simplex virus can reach the cerebrum and severely infect it. The infection develops from the inside out. It usually starts in the limbic zone, and then it spreads to the temporal and frontal lobes and infects the cerebrospinal fluid.
Cerebrum damage caused by herpes infection is manifested by signs and symptoms that I will tell you about in the third part of this article.
Herpes encephalitis incidence
According to medical statistics, each year there is one case of herpes encephalitis for every approximately 250000 people.
This disease affects people of both sexes and all ages, including children and the elderly.
Herpes encephalitis prognosis
The prognosis of a disease includes the effects it causes, its duration, and the chances of recovery. Affectations include complications and sequelae.
Survivors of this disease suffer neurological and psychological sequelae. These include:
- Memory impairment.
- Anosmia: decreased or lost sense of smell.
- Personality and behavioral disorders.
- Dysphasia: difficulty in the expression and comprehension of language.
- Dysarthria: speech disorder.
- Dysphagia: difficulty swallowing.
- Homonymous hemianopsia: vision disorder affecting the right or left half of the visual field of both eyes.
- Dyslexia: difficulty reading comprehension.
- Hyperphagia: excessive increase in the sensation of appetite.
- Ataxia: inability or irregularity in the coordination of voluntary muscle movements.
The duration of the disease is variable. Death may occur within seven to 14 days of onset of first symptoms in untreated patients.
Herpes encephalitis causes [↑]
There are eight types of viruses in the herpesvirus family that infect humans. Although several of these viruses can cause encephalitis, the phrase herpes encephalitis is used to designate encephalitis caused by herpes simplex viruses.
In 1968 Nahimas and Dowdle discovered there are two types of herpes simplex viruses: herpes simplex virus type 1 and herpes simplex virus type 2.
We know herpes simplex virus type 1 has the highest incidence, as approximately 90% of herpes encephalitis cases are caused by a virus of this type.
Transmission of the virus through contact with objects is less likely than through physical contact between a healthy person and an infected person. This is because the virus is destroyed if it remains outside the human body for more than two hours.
One way to transmit herpes simplex viruses through contact with objects is to use public restrooms. If a person with a genital herpes outbreak uses a toilet and is immediately followed by a healthy person, transmission of the virus to that person is likely.
There are also cases of double contagion in the transmission of the virus because infection by a virus of the first type does not immunize the host against infection by a virus of the second type and vice versa.
The most common form of herpes simplex virus type 1 infection is herpes labialis, while herpes simplex virus type 2 usually causes genital herpes.
These viruses have the ability to lodge in the nerve tissues of our body and remain in them for a long time, even a lifetime. When conditions are favorable, herpes outbreaks appear and if the virus infests the brain, the host suffers from herpes encephalitis.
Herpes encephalitis is not a contagious disease, only the virus that causes it is transmitted through physical contact with the lesions or body fluids of an infected person in a period of outbreaks or reactivation of the virus.
In addition to herpes simplex viruses, the following viruses from the herpesvirus family can cause encephalitis:
- Varicella zoster virus, which causes chickenpox and shingles.
- Cytomegalovirus (herpesvirus type 4), which causes severe retinitis in HIV patients and mononucleosis in patients of any type, regardless of whether or not their immune system is compromised.
- The Epstein-Barr virus (herpesvirus type 5), which causes infectious mononucleosis (kissing disease), Burkitt’s lymphoma and undifferentiated rhinopharyngeal carcinoma.
- Herpes virus type 6, causing childhood roseola.
Herpes encephalitis signs and symptoms [↑]
The symptoms of the disease vary from person to person, but usually herpes simplex encephalitis begins with flu-like symptoms such as cough, sore throat, and runny nose.
As the infection progresses, symptoms of neurological impairment are added to the initial symptoms.
As the infection progresses, symptoms worsen until the patient falls into a coma and dies, if left untreated.
Other symptoms of the disease in adults are anorexia, stiff neck, speech disturbances, abnormal behavior, and lethargy.
The signs and symptoms of herpes simplex encephalitis in newborns and older children differ from the signs and symptoms in adults.
In newborns or neonates (up to 27 days of age) the most common symptoms are lethargy, fever, and seizures.
In children over 27 days of age, the most common symptoms are fever, altered mental status (encephalopathy), altered consciousness, and seizures.
Herpes simplex encephalitis diagnosis [↑]
The diagnosis of herpes encephalitis is fundamentally clinical-microbiological.
When a patient presents with symptoms of the disease, a lumbar puncture2 is performed in which a sample of cerebrospinal fluid is extracted and examined in the laboratory for the virus.
For this reason the physician should indicate a lumbar puncture when a patient arrives at the hospital with symptoms of herpetic encephalitis because this procedure provides a diagnosis when treatment can be more successful.
The diagnosis of herpetic encephalitis can also be based on magnetic resonance imaging (MRI) and computed tomography (CT) as well as the results of an electroencephalograph.
Herpetic encephalitis prevention [↑]
Preventing illness in a person depends on whether or not he or she is infected with a herpes simplex virus.
Prevention in no infected people
One difficulty in preventing the spread of herpes simplex viruses is the existence of many infected people who do not know it because they have not had herpes symptoms.
The following measures are recommended to prevent the spread of the virus:
- Wash your hands thoroughly before touching your face or genitals.
- Do not share personal items with others.
- Use a latex condom during sex.
- Reduce the number of sexual partners.
- Avoid physical contact with people who have a herpes outbreak.
Pregnant women should tell their doctor if they have ever had an outbreak of herpes on vagina or in any other part of the body. If they don’t have a history of herpes, they can ask their doctor for a diagnosis for safety.
In the case of future mothers infected with the virus, a cesarean delivery is recommended in order to avoid the contagion of the baby.
Women who have an outbreak of herpes while breastfeeding should apply strict measures to prevent the baby from coming into contact with the affected area, clothing and other objects that have come into contact with the affected area, and genital fluids and saliva.
When the mother has a cold sore, she can protect the affected area with a hydrocolloid patch.
Prevention in infected people
At present, there are no drugs capable of definitively eliminating herpes simplex viruses from our organism. The available drugs and many natural remedies only serve to treat the effects of viruses, but they do not eliminate them (Table 1).
Acyclovir is one of the most commonly used antiviral agents to fight herpes simplex viruses. This drug is marketed in various forms including tablets, injections, creams and ointments.
In addition to acyclovir, there are other antiviral agents such as valacyclovir and famciclovir that are effective in fighting herpes simplex viruses. These drugs, like acyclovir, prevent the replication of the virus, but they do not permanently remove it from your body.
People infected with a herpes simplex virus should know preventive treatment with antiviral agents does not remove the virus from their body, and these drugs have several possible side effects that are harmful to their health.
Thanks to the research of a British doctor, motivated by the need to cure his daughter of genital herpes, a herpes treatment emerged which he called “The Ultimate Herpes Protocol”.
This protocol combines the use of natural remedies with medicines and was published in an English book that has been translated into Spanish and French.
|Table 1: Treatments to prevent herpes simplex encephalitis|
|Type of treatment||Effects against viruses||Side effects|
|Antiviral agents (acyclovir, valacyclovir, and famciclovir).||They prevent virus replication and reduce the time of herpes outbreaks, but they do not kill the virus.||Nausea, vomiting, headache, hair loss, abdominal pain, diarrhea and kidney failure.|
|Remedies with herbs and natural oils.||They help eliminate outbreaks, but they don’t eliminate the virus.||The use of some herbs can have harmful side effects.|
|The Ultimate Herpes Protocol.||Eliminates outbreaks and the virus.||No harmful side effects.|
If you suffer from herpes, do not want to continue suffering with this disease and want to avoid the danger of contracting herpes encephalitis, you can eliminate the virus definitively from your body with “The Ultimate Herpes Protocol”.
If you prefer the Spanish version of the book, you can download it here.
The Ultimate Herpes Protocol is also available in French at this link.
Herpes simplex encephalitis treatment [↑]
The patient’s condition and age are two important factors to consider in the treatment of herpes simplex encephalitis.
Treatment should be started as soon as possible, even without the results of the analysis of the cerebrospinal fluid from the lumbar puncture.
Herpes encephalitis treatment in adults
Herpes encephalitis in adults should be treated with intravenous acyclovir for at least 14 days.
At the end of this period, a control diagnosis of the presence of the virus should be made. If the virus is not detected, treatment can be stopped.
If, at the end of the first 14 days of treatment, the virus is detected, treatment should be continued and a control diagnosis made every seven days until the virus is not detected.
Although these results are not satisfactory, they are much higher than those achieved before the use of intravenous acyclovir in which mortality was around 70% of patients.
Herpetic encephalitis is a rarely recurrent disease. The few cases of recurrence that occur are mainly due to early discontinuation of treatment or the use of insufficient doses of acyclovir.
Treatment in children
In children, treatment is also done with intravenous acyclovir, but for 21 days.
A follow-up diagnosis should be made every seven days and an assessment should be made as to whether treatment needs to be stopped, varied or continued.
Outcomes of a study in patients treated with acyclovir
The Journal of Neurology, Neurosurgery, and Psychiatry published in 1997 a retrospective study3 based on a sample of 42 patients with herpes encephalitis treated with intravenous acyclovir in health institutions in Auckland and nearby localities, New Zealand, over the period 1983-1995.
The patients treated had an average age of 43 years. The youngest was a three-month-old child and the oldest was a 91-year-old.
Of the 42 patients treated with intravenous acyclovir, eight (19%) died. In four of them (9.5%) the death occurred during treatment and the remaining four (9.5%) died at a later time; one case two days after completion of treatment.
The age of the patients who did not survive was between 43 and 74 years; six of them were over 62 years of age. The younger and older patients survived the disease.
Five of these patients were evaluated in the first year after discharge. Two of them had a health condition that made evaluation difficult: one had dyslexia and the other had epilepsy and homonymous hemianopsia.
Of the 29 survivors evaluated, 20 (69%) had impaired memory, 19 (65%) had anosmia, 13 (45%) had personality and behavioural disorders, 12 (41%) had dysphasia, 7 (24%) had epilepsy and five (17.2%) had been treated for depression; two of them had attempted suicide.
Personality and behavioural disorders include two patients (6.8%) with obsessive-compulsive behaviour, one patient (3.4%) with aggressive behaviour and one patient (3.4%) with claustrophobia.
Other sequelae diagnosed in the 29 survivors were: 5 patients (17.2%) with dysarthria, three patients (10.3%) with dysphagia, two patients (6.9%) with unilateral weakness of the arm and one patient (3.4%) with hyperphagia.
The most common impairment occurred in memory, particularly in short-term memory.
Final notes [↑]
Herpetic encephalitis is an inflammation and irritation of the brain due to infection with the herpes simplex virus.
This disease affects people of any age, can cause death or produce severe neurological or psychological sequelae in a significant part of the patients who survive.
Herpes simplex virus type 1 is the most common cause of the disease.
The best way to prevent the disease is through a treatment that eliminates this virus from our body as The Ultimate Herpes Protocol.
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3. ↑ McGrath, N., Anderson, N. E., Croxson, M. C. y Powell, K. F. (1997). Herpes simplex encephalitis treated with acyclovir: diagnosis and long term outcome. Journal of Neurology, Neurosurgery, and Psychiatry, 63, 321–326. Information available at http://jnnp.bmj.com/