Peterslund N A
Department of Medicine and Infectious Diseases, Marselisborg Hospital, Aarhus, Denmark.
Scand J Infect Dis. 1988;20(6):583-92. doi: 10.3109/00365548809035658.
The clinical course of herpes zoster associated encephalitis (HZAE) with special emphasis on the treatment with acyclovir is described from the experience in 14 own patients and 47 review cases. Immunosuppression and dissemination involved increased risk of HZAE, whereas cranial zoster implied no or only a slightly increased risk. The symptoms were mainly disturbances of mental function and ataxia. Nuchal rigidity was noted in approximately one third of cases. The median duration from dermatomal lesion to HZAE was 15 days in immunosuppressed patients versus 5 days in non-immunosuppressed patients. Abnormal spinal fluid findings included mononuclear pleocytosis, occasionally with low glucose concentration. Protein was elevated in half of the patients. Serum sodium levels were often low. Brain CAT scans were generally normal and EEGs always abnormal. Recurrence of HZAE was noted in 2 patients. Treatment with acyclovir seemed to have a beneficial effect. The results, however, need cautious interpretation due to the heterogenous patient material. Two patients developed signs of HZAE while on treatment with desciclovir but recovered during ongoing therapy.
根据14例自身患者及47例回顾性病例的经验，描述了带状疱疹相关性脑炎（HZAE）的临床病程，特别强调了阿昔洛韦的治疗情况。免疫抑制和播散会增加HZAE的发病风险，而颅部带状疱疹的发病风险未增加或仅略有增加。症状主要为精神功能障碍和共济失调。约三分之一的病例出现颈项强直。免疫抑制患者从皮肤损害到HZAE的中位时间为15天，而非免疫抑制患者为5天。脑脊液异常表现包括单核细胞增多，偶有低糖浓度。半数患者蛋白升高。血清钠水平常降低。脑部CAT扫描通常正常，脑电图总是异常。2例患者出现HZAE复发。阿昔洛韦治疗似乎有有益效果。然而，由于患者材料的异质性，结果需要谨慎解读。2例患者在接受地昔洛韦治疗时出现HZAE症状，但在持续治疗过程中康复。
