Fujiki N, Tashiro K
Department of Neurology, Obihiro Kosei Hospital.
Nihon Rinsho. 1997 Apr;55(4):855-60.
Herpes simplex encephalitis is the commonest viral encephalitis among individuals, and the mortality has been markedly decreased by the use of vidarabine and acyclovir. Early diagnoses and immediate treatment are essential for favorable prognoses. Neuro-imagings, such as MRI and SPECT, and PCR technique for detection of HSV-DNA in CSF, are useful for early diagnoses, without requiring brain biopsy. Varicella and herpes zoster viruses are complicated, only rarely, with neurological manifestations, such as meningoencephalitis, myelitis, or peripheral neuropathy. Acyclovir is mostly effective in these cases. Neurological complications of Epstein-Barr virus infections are variable, including meningitis, cerebellar ataxia, cranial neuropathy, and Guillain-Barré syndrome. Their prognoses are generally good. Cytomegalovirus encephalitis is one of the common complications in AIDS patients. Its clinical diagnosis is difficult and the prognosis is considered to be poor.
单纯疱疹病毒性脑炎是个体中最常见的病毒性脑炎，使用阿糖腺苷和阿昔洛韦后死亡率已显著降低。早期诊断和立即治疗对于良好预后至关重要。神经影像学检查，如MRI和SPECT，以及检测脑脊液中HSV-DNA的PCR技术，对于早期诊断很有用，无需进行脑活检。水痘和带状疱疹病毒很少并发神经系统表现，如脑膜脑炎、脊髓炎或周围神经病。阿昔洛韦在这些病例中大多有效。EB病毒感染的神经系统并发症多种多样，包括脑膜炎、小脑共济失调、颅神经病变和格林-巴利综合征。其预后一般良好。巨细胞病毒性脑炎是艾滋病患者常见的并发症之一。其临床诊断困难，预后被认为很差。
