herpes simplex encephalitis

Summary

Summary: An acute (or rarely chronic) inflammatory process of the brain caused by SIMPLEXVIRUS infections which may be fatal. The majority of infections are caused by human herpesvirus 1 (HERPESVIRUS 1, HUMAN) and less often by human herpesvirus 2 (HERPESVIRUS 2, HUMAN). Clinical manifestations include FEVER; HEADACHE; SEIZURES; HALLUCINATIONS; behavioral alterations; APHASIA; hemiparesis; and COMA. Pathologically, the condition is marked by a hemorrhagic necrosis involving the medial and inferior TEMPORAL LOBE and orbital regions of the FRONTAL LOBE. (From Adams et al., Principles of Neurology, 6th ed, pp751-4)

Top Publications

  1. Kennedy P, Chaudhuri A. Herpes simplex encephalitis. J Neurol Neurosurg Psychiatry. 2002;73:237-8 pubmed
  2. De Tiège X, Rozenberg F, Burlot K, Gaudelus J, Ponsot G, Heron B. Herpes simplex encephalitis: diagnostic problems and late relapse. Dev Med Child Neurol. 2006;48:60-3 pubmed
    ..Delayed intrathecal synthesis of specific anti-HSV antibodies was found on day 26 and confirmed herpes simplex encephalitis (HSE) diagnosis...
  3. Al Shekhlee A, Kocharian N, Suarez J. Re-evaluating the diagnostic methods in herpes simplex encephalitis. Herpes. 2006;13:17-9 pubmed
    Several methods are used in clinical practice to investigate herpes simplex encephalitis (HSE), including electroencephalography (EEG) and polymerase chain reaction (PCR) of the viral genome in cerebrospinal fluid...
  4. Sköldenberg B, Aurelius E, Hjalmarsson A, Sabri F, Forsgren M, Andersson B, et al. Incidence and pathogenesis of clinical relapse after herpes simplex encephalitis in adults. J Neurol. 2006;253:163-70 pubmed
    To study the occurrence of relapse of herpes simplex encephalitis (HSE) and to find out whether soluble activity markers in cerebrospinal fluid (CSF) indicate direct viral or immune- mediated events.
  5. Zhang S, Jouanguy E, Ugolini S, Smahi A, Elain G, Romero P, et al. TLR3 deficiency in patients with herpes simplex encephalitis. Science. 2007;317:1522-7 pubmed
    ..Human TLR3 appears to be redundant in host defense to most microbes but is vital for natural immunity to HSV-1 in the CNS, which suggests that neurotropic viruses have contributed to the evolutionary maintenance of TLR3...
  6. Politei J, Demey I, Pagano M. [Cerebral haematoma in the course of herpes simplex encephalitis]. Rev Neurol. 2003;36:636-9 pubmed
    b>Herpes simplex encephalitis (HSE) is the most common cause of infectious encephalitis at all ages...
  7. Pérez de Diego R, Sancho Shimizu V, Lorenzo L, Puel A, Plancoulaine S, Picard C, et al. Human TRAF3 adaptor molecule deficiency leads to impaired Toll-like receptor 3 response and susceptibility to herpes simplex encephalitis. Immunity. 2010;33:400-11 pubmed publisher
    ..Thus, TLR3-mediated immunity against primary infection by HSV-1 in the central nervous system is critically dependent on TRAF3...
  8. Kuker W, Nagele T, Schmidt F, Heckl S, Herrlinger U. Diffusion-weighted MRI in herpes simplex encephalitis: a report of three cases. Neuroradiology. 2004;46:122-5 pubmed
    ..Thus, DW-MRI may be a valuable tool for early detection and diagnosis of HSVE whereas contrast-enhanced images are indispensable after the first week...
  9. James S, Kimberlin D, Whitley R. Antiviral therapy for herpesvirus central nervous system infections: neonatal herpes simplex virus infection, herpes simplex encephalitis, and congenital cytomegalovirus infection. Antiviral Res. 2009;83:207-13 pubmed publisher
    ..Although advances in antiviral agents have led to improved outcomes, there is still a need for more effective treatments...

More Information

Publications62

  1. Raschilas F, Wolff M, Delatour F, Chaffaut C, de Broucker T, Chevret S, et al. Outcome of and prognostic factors for herpes simplex encephalitis in adult patients: results of a multicenter study. Clin Infect Dis. 2002;35:254-60 pubmed
    Management of herpes simplex encephalitis (HSE) has been considerably improved by the availability of acyclovir therapy and rapid polymerase chain reaction (PCR)-based diagnostic assays...
  2. Sauerbrei A, Wutzler P. Laboratory diagnosis of central nervous system infections caused by herpesviruses. J Clin Virol. 2002;25 Suppl 1:S45-51 pubmed
    Herpesviruses may be associated with various types of central nervous system (CNS) infections. Herpes simplex encephalitis (HSE) has to be considered one of the most severe diseases...
  3. Wasay M, Mekan S, Khelaeni B, Saeed Z, Hassan A, Cheema Z, et al. Extra temporal involvement in herpes simplex encephalitis. Eur J Neurol. 2005;12:475-9 pubmed
    Temporal lobe abnormalities on brain imaging have been described as strong evidence for herpes simplex encephalitis (HSE) in appropriate clinical settings. Extra temporal abnormalities are less well described in these patients...
  4. Tyler K. Herpes simplex virus infections of the central nervous system: encephalitis and meningitis, including Mollaret's. Herpes. 2004;11 Suppl 2:57A-64A pubmed
    b>Herpes simplex encephalitis (HSE) is a life-threatening consequence of herpes simplex virus (HSV) infection of the central nervous system (CNS)...
  5. Wong S, Smith D, Fallon M, Kermode A. Murray valley encephalitis mimicking herpes simplex encephalitis. J Clin Neurosci. 2005;12:822-4 pubmed
    ..Valley encephalitis (MVE), whose presentation was clinically and radiologically characteristic of Herpes simplex encephalitis (HSE)...
  6. Martinez Torres F, Wagner S, Haas J, Kehm R, Sellner J, Hacke W, et al. Increased presence of matrix metalloproteinases 2 and 9 in short- and long-term experimental herpes simplex virus encephalitis. Neurosci Lett. 2004;368:274-8 pubmed
    ..Increased presence of MMP2 and MMP9 in chronic HSVE may contribute to ongoing damage. Inhibition of MMP2 and MMP9 might be a suitable target for therapeutic intervention...
  7. Chataway J, Davies N, Farmer S, Howard R, Thompson E, Ward K. Herpes simplex encephalitis: an audit of the use of laboratory diagnostic tests. QJM. 2004;97:325-30 pubmed
    The combination of both PCR and intrathecal antibody studies is recommended to confirm or refute the diagnosis of herpes simplex encephalitis (HSE).
  8. Hsieh W, Chiu N, Hu K, Ho C, Huang F. Outcome of herpes simplex encephalitis in children. J Microbiol Immunol Infect. 2007;40:34-8 pubmed
    b>Herpes simplex encephalitis (HSE) can cause high mortality and morbidity in children. Since local data of HSE in children are rare, we performed a retrospective study to evaluate the prognostic factors and outcome of HSE in Taiwan.
  9. Jackson A, Rossiter J, Lafon M. Expression of Toll-like receptor 3 in the human cerebellar cortex in rabies, herpes simplex encephalitis, and other neurological diseases. J Neurovirol. 2006;12:229-34 pubmed
    ..Purkinje cells were found to express TLR-3 in all cases of rabies (4 of 4) and herpes simplex encephalitis (2 of 2) as well as in cases of amyotrophic lateral sclerosis (1 of 2), stroke (1 of 2), and Alzheimer'..
  10. Sawlani V. Diffusion-weighted imaging and apparent diffusion coefficient evaluation of herpes simplex encephalitis and Japanese encephalitis. J Neurol Sci. 2009;287:221-6 pubmed publisher
    ..imaging (DWI) and apparent diffusion coefficient (ADC) values in differentiating necrotising herpes simplex encephalitis (HSE) and non-necrotising Japanese encephalitis (JE) and (b) to correlate the ADC values with the ..
  11. Kamei S, Sekizawa T, Shiota H, Mizutani T, Itoyama Y, Takasu T, et al. Evaluation of combination therapy using aciclovir and corticosteroid in adult patients with herpes simplex virus encephalitis. J Neurol Neurosurg Psychiatry. 2005;76:1544-9 pubmed
    ..In the present investigation, the first to assess efficacy of corticosteroid treatment with aciclovir therapy in HSVE, multiple logistic regression analysis was performed of predictors of outcome in adult patients with HSVE...
  12. Laws K, Sartori G. Category deficits and paradoxical dissociations in Alzheimer's disease and Herpes Simplex Encephalitis. J Cogn Neurosci. 2005;17:1453-9 pubmed
    ..frequently accompanied by impaired semantic memory (19 patients with Alzheimer's disease and 15 with Herpes Simplex Encephalitis)...
  13. Hjalmarsson A, Granath F, Forsgren M, Brytting M, Blomqvist P, Sköldenberg B. Prognostic value of intrathecal antibody production and DNA viral load in cerebrospinal fluid of patients with herpes simplex encephalitis. J Neurol. 2009;256:1243-51 pubmed publisher
    b>Herpes simplex encephalitis is a devastating disease...
  14. Studahl M, Günther G, Rosengren L. Serum S-100B protein levels in patients with herpes simplex encephalitis and tick-borne encephalitis--a marker of CNS damage during the initial stage of disease. J Neurol. 2009;256:586-90 pubmed publisher
    This study was mainly aimed at the comparative analysis of serum S-100B protein in patients with herpes simplex encephalitis (HSE) and tick-borne encephalitis (TBE)...
  15. Bradford R, Pettit A, Wright P, Mulligan M, Moreland L, McLain D, et al. Herpes simplex encephalitis during treatment with tumor necrosis factor-alpha inhibitors. Clin Infect Dis. 2009;49:924-7 pubmed publisher
    ..Although TNF-alpha inhibitors have been reported to increase the risk of other infectious diseases, to our knowledge, an association between anti-TNF-alpha drugs and herpes simplex virus encephalitis has not been previously described...
  16. De Tiège X, De Laet C, Mazoin N, Christophe C, Mewasingh L, Wetzburger C, et al. Postinfectious immune-mediated encephalitis after pediatric herpes simplex encephalitis. Brain Dev. 2005;27:304-7 pubmed
    ..deterioration clinically characterized by a partial Kluver-Bucy syndrome, 1 month after the onset of herpes simplex encephalitis. This episode is unlikely due to continuation or resumption of cerebral viral replication but might be ..
  17. Khetsuriani N, Holman R, Anderson L. Burden of encephalitis-associated hospitalizations in the United States, 1988-1997. Clin Infect Dis. 2002;35:175-82 pubmed
    ..The average cost of an encephalitis-associated hospitalization, as determined by the Healthcare Cost and Utilization Project for 1997, was $28,151, for an annual national cost of hospitalization of $650 million...
  18. Jha S, Patel R, Yadav R, Kumar V. Clinical spectrum, pitfalls in diagnosis and therapeutic implications in herpes simplex encephalitis. J Assoc Physicians India. 2004;52:24-6 pubmed
    High index of suspicion is mandatory for early diagnosis of Herpes Simplex Encephalitis (HSE), since acyclovir therapy can prevent its mortality and limit morbidity...
  19. Whitley R, Kimberlin D. Herpes simplex encephalitis: children and adolescents. Semin Pediatr Infect Dis. 2005;16:17-23 pubmed
    b>Herpes simplex encephalitis (HSE) remains one of the most devastating infections of the central nervous system despite available antiviral therapy. Children and adolescents account for approximately one third of all cases of HSE...
  20. Yamada S, Kameyama T, Nagaya S, Hashizume Y, Yoshida M. Relapsing herpes simplex encephalitis: pathological confirmation of viral reactivation. J Neurol Neurosurg Psychiatry. 2003;74:262-4 pubmed
    This case is reported to raise awareness of herpes simplex encephalitis as a persisting brain disorder...
  21. Joos A, Ziyeh S, Rauer S, Keller E, Huzly D, Lucking C. Postinfectious autoimmune-mediated encephalitis eight months after herpes simplex encephalitis. Eur Neurol. 2003;50:54-6 pubmed
  22. Vilela M, Mansur D, Lacerda Queiroz N, Rodrigues D, Arantes R, Kroon E, et al. Traffic of leukocytes in the central nervous system is associated with chemokine up-regulation in a severe model of herpes simplex encephalitis: an intravital microscopy study. Neurosci Lett. 2008;445:18-22 pubmed publisher
    ..These results corroborate the role of chemokines in leukocyte recruitment following HSV-1 infection in the central nervous system...
  23. Obeid M, Franklin J, Shrestha S, Johnson L, Quattromani F, Hurst D. Diffusion-weighted imaging findings on MRI as the sole radiographic findings in a child with proven herpes simplex encephalitis. Pediatr Radiol. 2007;37:1159-62 pubmed
    We present a case of herpes simplex encephalitis in an 8-year-old girl, in whom hyperintensity was detected on diffusion-weighted imaging (DWI) while conventional MRI sequences were normal 1 week after the onset of neurological symptoms...
  24. Jacobi C, Lange P, Reiber H. Quantitation of intrathecal antibodies in cerebrospinal fluid of subacute sclerosing panencephalitis, herpes simplex encephalitis and multiple sclerosis: discrimination between microorganism-driven and polyspecific immune response. J Neuroimmunol. 2007;187:139-46 pubmed
    ..for HSV or measles has about 20- to 60-fold higher values in virus-caused antibody synthesis in acute herpes simplex encephalitis (mean HSV-F(S)=8.9%) or subacute sclerosing panencephalitis (mean measles-F(S)=18...
  25. Denaro F, Staub P, Colmer J, Freed D. Coexistence of Alzheimer disease neuropathology with herpes simplex encephalitis. Cell Mol Biol (Noisy-le-grand). 2003;49:1233-40 pubmed
    ..Such may be the case if there is reactivation of a previously undiagnosed herpes virus infection. With the development of PCR and in situ hybridization diagnosis will be simplified and more definitive...
  26. Jabłkowski M, Kolasa P, Szubert W, Białkowska J. Herpes simplex encephalitis: a case report. Med Sci Monit. 2004;10:CS41-5 pubmed
    Despite advances in antiviral therapy over the past 2 decades, herpes simplex encephalitis (HSE) remains a serious illness with significant risk of morbidity and death...
  27. Kurtz J, Anslow P. Infantile herpes simplex encephalitis: diagnostic features and differentiation from non-accidental injury. J Infect. 2003;46:12-6 pubmed
    ..After a baby, subsequently proven to have HSE, had initially been diagnosed as non-accidental injury (NAI), we reviewed the clinical features and radiology of infants with HSE recently diagnosed by our laboratory...
  28. Ichiyama T, Shoji H, Takahashi Y, Matsushige T, Kajimoto M, Inuzuka T, et al. Cerebrospinal fluid levels of cytokines in non-herpetic acute limbic encephalitis: comparison with herpes simplex encephalitis. Cytokine. 2008;44:149-53 pubmed publisher
    ..Recently, non-herpetic acute limbic encephalitis (NHALE) was identified as a new subgroup of limbic encephalitis. The immunological pathophysiology of NHALE is still unclear...
  29. Biswas A, Das S, Roy T, Dhibar T, Ghorai S. Acute intracerebral haematoma--an unusual presentation of herpes simplex encephalitis. J Assoc Physicians India. 2004;52:69-71 pubmed
    ..The patient made an excellent recovery following a course of acyclovir. Frank intracerebral haematoma in the form of well defined mass on CT scan in patient with herpes simplex encephalitis is extremely rare.
  30. Kimura H. [Herpes simplex encephalitis in childhood]. Rinsho Shinkeigaku. 2006;46:958-60 pubmed
    Central nervous system (CNS) infection by herpes simplex virus (HSV) in childhood consists of herpes simplex encephalitis and CNS infections in neonates...
  31. Elbers J, Bitnun A, Richardson S, Ford Jones E, Tellier R, Wald R, et al. A 12-year prospective study of childhood herpes simplex encephalitis: is there a broader spectrum of disease?. Pediatrics. 2007;119:e399-407 pubmed
    The purpose of this study was to review the experience with herpes simplex encephalitis at the Hospital for Sick Children over the past 12 years.
  32. Mitsufuji N, Ikuta H. Asymptomatic self-limiting white matter lesions in the chronic phase of herpes simplex encephalitis. Brain Dev. 2002;24:300-3 pubmed
    We report a 9-month-old girl with herpes simplex encephalitis. T(2)-weighted magnetic resonance imaging (MRI) on the 8th day of illness showed increased signal intensity in the gray and white matter of the bilateral lobes, especially the ..
  33. McCabe K, Tyler K, Tanabe J. Diffusion-weighted MRI abnormalities as a clue to the diagnosis of herpes simplex encephalitis. Neurology. 2003;61:1015-6 pubmed
  34. Protopsaltis J, Kokkoris S, Brestas P, Chrysos G, Salvanos L, Samara C, et al. Neurolisteriosis mimicking herpes simplex encephalitis in an immunocompromized patient. Scand J Infect Dis. 2006;38:825-8 pubmed
    ..Nevertheless, PCR in CSF for Listeria monocytogens was positive. This case implies that Listeria might be considered in patients with clinical and imaging suspicion of herpetic encephalitis...
  35. Ueda N, Miyasaki H, Kuroiwa Y. Diffuse white matter lesions in a case of herpes simplex encephalitis. J Neurol. 2003;250:867-8 pubmed
  36. De Tiège X, Rozenberg F, Heron B. The spectrum of herpes simplex encephalitis in children. Eur J Paediatr Neurol. 2008;12:72-81 pubmed
    Clinical and basic science research carried out in recent years into herpes simplex encephalitis (HSE) have shown that the concept of a "classical" picture of HSE in children is now outdated and that our current knowledge of ..
  37. De Tiege X, Rozenberg F, Des Portes V, Lobut J, Lebon P, Ponsot G, et al. Herpes simplex encephalitis relapses in children: differentiation of two neurologic entities. Neurology. 2003;61:241-3 pubmed
    Relapses of herpes simplex encephalitis (HSE) occurring after the completion of antiviral treatment have been reported repeatedly in children. The authors report data on six children who had at least one relapse of HSE...
  38. Weil A, Glaser C, Amad Z, Forghani B. Patients with suspected herpes simplex encephalitis: rethinking an initial negative polymerase chain reaction result. Clin Infect Dis. 2002;34:1154-7 pubmed
    A statewide encephalitis diagnostic project of the California State Department of Health Services found that herpes simplex virus 1 DNA may not be detectable by molecular methods early in the clinical course of herpes simplex encephalitis.
  39. Bayram N, Ciftdogan D, Karapinar B, Ozgiray E, Polat M, Cagliyan E, et al. A case of herpes simplex encephalitis revealed by decompressive craniectomy. Eur J Pediatr. 2008;167:821-2 pubmed
    ..Her clinical signs and cerebral imaging findings were found to be compatible with herpes simplex encephalitis. In spite of prompt acyclovir administration, her consciousness deteriorated gradually...
  40. Taylor S, Lee D, Jackson A. Herpes simplex encephalitis presenting with exclusively frontal lobe involvement. J Neurovirol. 2007;13:477-81 pubmed
    The authors report a patient with herpes simplex encephalitis who presented with magnetic resonance imaging (MRI) lesions exclusively in the frontal lobes, including the bilateral anterior cingulate gyri...
  41. Kullnat M, Morse R. Choreoathetosis after herpes simplex encephalitis with basal ganglia involvement on MRI. Pediatrics. 2008;121:e1003-7 pubmed publisher
  42. Whitley R. Herpes simplex encephalitis: adolescents and adults. Antiviral Res. 2006;71:141-8 pubmed
    b>Herpes simplex encephalitis (HSE) remains one of the most devastating infections of the central nervous system despite available antiviral therapy. Children and adolescents account for approximately one third of all cases of HSE...
  43. Vilela M, Mansur D, Lacerda Queiroz N, Rodrigues D, Lima G, Arantes R, et al. The chemokine CCL5 is essential for leukocyte recruitment in a model of severe Herpes simplex encephalitis. Ann N Y Acad Sci. 2009;1153:256-63 pubmed publisher
    ..However, blocking of CCR1 and CCR5 did not affect HSV-1 replication, suggesting that other immune mechanisms are involved in the process of infection control...
  44. Mondal G, Kumar R, Ghosh J, Basu K, Chatterjee S. Basal ganglia involvement in a child with herpes simplex encephalitis. Indian J Pediatr. 2009;76:749-50 pubmed publisher
    b>Herpes simplex encephalitis (HSE) is a leading cause of sporadic, nonepidemic viral encephalitis in children and adults...
  45. Grest P, Albicker P, Hoelzle L, Wild P, Pospischil A. Herpes simplex encephalitis in a domestic rabbit (Oryctolagus cuniculus). J Comp Pathol. 2002;126:308-11 pubmed
    ..The agent was classified as HSV-1 by polymerase chain reaction analysis. This is only the second reported natural case of herpes simplex infection in a rabbit...
  46. Sellner J, Dvorak F, Zhou Y, Haas J, Kehm R, Wildemann B, et al. Acute and long-term alteration of chemokine mRNA expression after anti-viral and anti-inflammatory treatment in herpes simplex virus encephalitis. Neurosci Lett. 2005;374:197-202 pubmed
    ..This pattern was substantially altered by anti-viral and anti-inflammatory treatment. Our findings indicate a pivotal role of these chemokines in the immunopathogenesis of HSVE...
  47. Vieira Santos A, Matias S, Saraiva P, Goulao A. Differential diagnosis of mesiotemporal lesions: case report of neurosyphilis. Neuroradiology. 2005;47:664-7 pubmed
    We report a clinical and imaging case of suspected herpes simplex encephalitis subsequently diagnosed as neurosyphilis based on positive antibodies in the CSF...
  48. Auyeung P, Dunn A. Atypical case of Herpes simplex encephalitis. Intern Med J. 2008;38:294-5 pubmed publisher
  49. Hjalmarsson A, Blomqvist P, Sköldenberg B. Herpes simplex encephalitis in Sweden, 1990-2001: incidence, morbidity, and mortality. Clin Infect Dis. 2007;45:875-80 pubmed
    b>Herpes simplex encephalitis (HSE) is a devastating disease.
  50. Gaviani P, Leone M, Mula M, Naldi P, Macchiarulo E, Brustia D, et al. Progression of MRI abnormalities in herpes simplex encephalitis despite clinical improvement: natural history or disease progression?. Neurol Sci. 2004;25:104-7 pubmed
    ..Imaging studies of a cohort of patients surviving PCR-confirmed HSVE are needed to determine whether this pattern is occasional or a frequent form of progression...
  51. Hu Z, Yang Q, Bo X, Li J. Herpes simplex encephalitis. Lancet. 2003;362:280 pubmed
  52. Tyler K. Update on herpes simplex encephalitis. Rev Neurol Dis. 2004;1:169-78 pubmed
    b>Herpes simplex encephalitis is the most common identified cause of sporadic viral encephalitis in the United States...
  53. Jha S, Jose M, Kumar V. Herpes simplex encephalitis: some interesting presentations. Neurol India. 2003;51:399-400 pubmed
    b>Herpes Simplex Encephalitis (HSE) is the most common cause of fatal viral encephalitis. A high index of suspicion is mandatory for early diagnosis and successful therapy to restrict morbidity and mortality...