Department of Neurology/Internal Medicine, Security Forces Hospital, Makkah, Saudi Arabia.
Neurologist. 2021 Sep 7;26(5):178-184. doi: 10.1097/NRL.0000000000000343.
The typical herpes simplex viral encephalitis (HSVE) course is an acute illness, less commonly it may present as a chronic course, mainly in children, and rarely may it be subacute. Subacute HSVE is rarely described in the literature being reported 4 times only.
We here report 2 cases of subacute HSV1 encephalitis diagnosed based on cerebrospinal fluid polymerase chain reaction and magnetic resonance imaging findings and review the literature trying to find any specific clinical, laboratory, radiologic diagnostic or prognostic criteria regarding this subacute form of HSVE.
There is subacute form of HSVE and should be suspected with any subacute febrile illness with nonspecific cognitive impairment even in the absence of focal neurological symptoms and in cases with rapidly progressive dementia. This form has similar radiologic finding and good response to acyclovir but carry even better prognosis than that the acute HSVE.
典型的单纯疱疹病毒性脑炎(HSVE)病程为急性,较少见的情况下可能呈慢性病程,主要见于儿童,极少见亚急性。亚急性 HSVE 在文献中很少见,仅报道过 4 次。
我们在此报告 2 例基于脑脊液聚合酶链反应和磁共振成像结果诊断的亚急性 HSV1 脑炎,并复习文献,试图找到关于这种亚急性 HSVE 的任何特定临床、实验室、影像学诊断或预后标准。
存在亚急性 HSVE,应怀疑任何亚急性发热性疾病伴有非特异性认知障碍,即使没有局灶性神经症状,以及在快速进行性痴呆的情况下。这种形式具有类似的放射学表现,对阿昔洛韦反应良好,但预后优于急性 HSVE。