There are mainly two types of herpes simplex viruses,HSV 1,HSV 2,.This most commonly affects the neonates.
ASSESSMENT AND DIAGNOSTIC FINDINGS
- History collection and physical examination
- Neuroimaging studies(MRI)
- Electro encephalography
- CSF examination to diagnose HSV encephalitis.
- EEG demonstrates spikes
- Lumbar puncture demonstrates low glucose and high protein levels.
- Polymerase chain reaction(PSR)
- HSV-1 virus causes inflammation and necrosis of the temporal lobe.
- Fever,headache and confusion are the initial symptoms.
- Behavioral changes,
- focal seizures,
- hemiparesis and
- altered level of consciousness
PATHOPHYSIOLOGYThe olfactory and the trigeminal nerves are the most commonly involved pathways.
- Acyclovir(Zovirax),antiviral agent.To prevent relapse the treatment has to be continued for three weeks,slow IV administration of the drug prevents the crystallization of the drug in the urine.
- Valacyclovir is also given for the treatment of encephalitis.
- Neurological assessment for monitoring the progression of the disease.
- Comfort measures to reduce headache like dimming the light,reducing the noise and administering the analgesics.
- Opiod analgesics masks the neurological symptoms so it is less preffered.
- If seizures and altered loss of consciousness is present the patient must be protected from injury.
HERPES SIMPLEX VIRUS ENCEPHALITIS
Labels: Central Nervous System