Herpes simplex virus can be found in 80% of the population. Basically, it is in a dormant state in neurons, being activated when immunity is reduced, and affects mainly the skin, mucous membranes of the lips, eyes, and genitals. But in severe cases, it can cause a disease called "herpetic encephalitis", characterized by damage to the nervous system.
The concept of pathology
This acute infectious disease originates in the brain. Herpetic encephalitis is usually caused by the herpes simplex virus type 1 (about 95% of cases). It is considered a complication of herpesvirus infection, leading to damage to the temporal and frontal parts of the brain.
The peaks of the disease occur in young people from 5 to 25 years old, as well as people over 50 years old. The main flow of patients with a similar pathology is observed in the spring season. It can develop immediately after infection (inmainly occurs in children) or during an exacerbation of an infection inside the body (mainly in adults), supplemented by diseases such as chickenpox, herpes zoster, infectious mononucleosis, or herpetic lesions of the genitals or nasolabial triangle.
Of all types of acute encephalitis, this variety accounts for more than 10% of cases, which makes it possible to attribute this disease to a fairly common one.
Mostly his children pick him up. This is due to the fact that they have an underdeveloped blood-brain barrier through which the virus enters the brain.
Grounds for occurrence in adults
The causes of herpes encephalitis are that the herpes simplex virus enters the human body through the oral mucosa, and then moves through the nerve cells through the axons of the olfactory neurons. But getting into the body does not mean damage to the brain. For in unfavorable conditions for itself, the virus goes into a dormant state and is activated only when immunity is reduced.
The risk of developing this disease increases with:
- diseases associated with immunodeficiency;
- stressful situations for a long time;
- respiratory infections;
- oncology;
- stroke;
- brain injury.
It mainly occurs as a result of a complication of herpes simplex, which is manifested by rashes in the nasal mucosa and oral cavity. Much less often, viral herpetic encephalitis develops against the background of genital.
For todayday there are two hypotheses for the existence of this disease:
- resumption of activity of virus particles in the nerve ganglia contributes to its spread along the nerves;
- he is in a dormant state in nerve cells, from where he reactivates.
Signs in children
Newborns can be born with this pathology with intrauterine infection from the mother. The baby is born with increased intracranial pressure.
The main signs of the disease in this case are as follows:
- protruding fontanel on the skull;
- tearfulness;
- vomit;
- constant screams, escalating when waking up in the morning;
- lack of appetite;
- hyperexcitability;
- motor anxiety.
In addition to the brain, other organs and systems of the body can be affected in a newborn:
- spleen;
- kidneys;
- light;
- liver.
Herpetic encephalitis can appear after suffering gingivitis, stomatitis and other diseases of a similar nature, that is, when the virus enters the brain through the trigeminal nerve.
Clinical picture
Symptoms of herpetic encephalitis:
- rashes appear in the mouth, nasal mucosa, on the skin;
- temperature increases, which is difficult to reduce when using antipyretics;
- headaches appear;
- convulsions occur throughout the body, hardly stopped by medicationdrugs;
- thought processes are disturbed, the patient's behavior changes;
- there is a disturbance in the sense of reality, which can lead to coma or hearing loss;
- neurological disorders noted.
Some symptoms in adults of herpetic encephalitis do not appear in all cases and are individual. These include:
- appearance of double vision or sideways glance;
- nervous excitement;
- tachycardia;
- increased blood pressure;
- movement disorder;
- distorted speech;
- paralysis of limbs on one side;
- memory lapses;
- hyperhidrosis;
- appearance of hallucinations, indicating a malfunction in the central nervous system, requiring immediate treatment.
Slow pathology
In relation to the disease in question, its sluggish form is distinguished. At the same time, the central nervous system undergoes chronic inflammation, which contributes to the development of asthenic syndrome and an increase in body temperature. Six months later, encephalitis develops, characterized by focal lesions of the brain. Patients present with the following symptoms:
- muscular dystonia;
- reflex asymmetry;
- unilateral paralysis;
- short convulsions.
As a rule, this form of the disease ends in the death of the patient due to late diagnosis and the resistance of viruses to Acyclovir.
Prevention
Mostly, herpetic encephalitis infection is carried out by airborne droplets, so the set of preventive measures generally coincides with those for a cold, and also includes general recommendations for preventing genital infections:
- immunity boost;
- protected sex using condoms;
- avoid contact with patients and carriers of the virus;
- taking a multivitamin.
It must be understood that this pathology is dangerous and can lead to irreversible brain dynamics and human death.
Diagnosis
It is carried out by conducting CT and MRI of the brain. The type of pathogen is determined by the analysis of cerebrospinal fluid and blood using PCR. But the amount of antibodies in them increases only 10 days after infection, so this method is used only to confirm the diagnosis and the appropriateness of the therapy.
Also ordered a brain biopsy. In addition, CSF examinations can be carried out and, as a retrospective type of diagnosis, serological reactions.
It is most important to undergo an MRI or CT as soon as possible, as this allows you to identify the exact cause of the pathology. Here the stage of the disease is determined, after which doctors can make any predictions.
After the examination, various diagnoses can be made:
- cerebral vasculitis;
- viral encephalitis;
- toxic-type encephalopathy;
- acute disseminated encephalomyelitis.
Treatment
The patient is placed in the intensive care unit or intensive care unit to prevent the development of dysgraphia and respiratory disorders. Treatment of herpetic encephalitis is carried out with drugs such as:
- "Zovirax";
- "Virolex";
- "Aciclovir".
They can be taken orally or, if the patient is seriously ill, given by injection.
The first two days after the patient is admitted to the hospital, he is given high doses of these drugs (10-15 mg/kg body 3 times a day). Thanks to this, it is possible to reduce mortality from this disease and prevent serious consequences. Therapy usually continues for 7-14 days. In the hospital, the body is detoxified, restoring the water-s alt balance.
Some doctors prescribe interferons, but studies in Europe do not show the effectiveness of these drugs. With the onset of cerebral edema, corticosteroids are taken for no more than 7 days. When the patient is in a coma, ventilation of the lungs and tracheal intubation are carried out.
In addition, diuretics may be prescribed to relieve cerebral edema. If the body is dehydrated, the patient is prescribed droppers with a solution of ascorbic acid.
In severe cases, nootropics may be prescribed.
Complications
Consequences of herpetic encephalitisalmost always very severe and are of a mental and neurological nature:
- decrease in attention;
- memory deterioration;
- paralysis;
- appearance of apathy;
- increased fatigue;
- discoordination;
- vision deterioration;
- hearing loss;
- appearance of dizziness and headaches;
- drowsy;
- dementia leading to cognitive impairment (the appearance of dementia with the loss of acquired knowledge and the inability to acquire new ones);
- deterioration of coherence of speech;
- decrease in intelligence;
- falling away or a sharp decrease in tactile sensations;
- appearance of irritability and aggressiveness;
- urinary incontinence.
With a mild course of the disease, increased immunity, the therapy used, depending on the age of the patient, a person can return to a full life, since these consequences may not be expressed at all or be mild.
Intracranial hypertension syndrome may develop in young children. This is due to the fact that the circulation of intracerebral fluid is impaired.
The disease itself is not as dangerous as its consequences.
Forecast
The main problem of this pathology is that during the incubation period it is quite difficult to detect. After the symptoms become pronounced, the infection has affected the brain deeply enough that the process is difficult to stop.
The prognosis of herpetic encephalitis can be positive if it is detected early and treated promptly. In the case of the onset of the disease, it is rather disappointing: adverse consequences may occur, up to the death of the patient. The most sad forecasts are when patients with herpetic encephalitis of the brain fall into a coma. According to statistics, only 10% of patients get out of it, the rest die.
Sometimes the pathology is formed very rapidly. This contributes to severe swelling of the brain, which leads to respiratory arrest. The patient in this case rarely survives. If this happens, the signs of this disease will remain with him for a long time. It is very rare to see a full recovery of a person's he alth.
In conclusion
Herpetic encephalitis is a rather dangerous disease observed most often in children. In case of untimely detection, a child or an adult with a similar pathology may remain disabled, receive minor complications with timely treatment, or die with late or incorrect diagnosis. Prevention is mainly to increase the body's immunity.
