Herpes simplex virus can be detected in 80% of the population. Basically, he is in a sleeping state in neurons, activating with a decrease in immunity, and affects mainly the skin, mucous membranes of the lips, eyes, 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 occurs in the brain. Herpetic encephalitis is usually caused by the herpes simplex virus of the first type (about 95% of cases). It is considered a complication of herpesvirus infection, leading to damage to the temporal and frontal parts of the brain.
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 noted in the spring season. It can develop immediately after infection (mainly found in children) or with an exacerbation of the infection inside the body (mainly in adults), supplemented by diseases such as chickenpox, shingles, infectious mononucleosis, or herpetic lesions of the genitals or nasolabial triangle.
Of all types of acute encephalitis, this species accounts for more than 10% of cases, which makes it possible to classify this disease as quite common.
Mostly picked up by his children. This is due to the fact that they have not developed the blood-brain barrier through which the virus enters the brain.
The reasons for the occurrence in adults
The causes of herpetic encephalitis are that the herpes simplex virus enters the human body through the oral mucosa, and then moves through nerve cells through the axons of olfactory neurons. But getting into the body does not mean brain damage. For in adverse conditions for itself, the virus goes into a sleeping state and is activated only with a decrease in immunity.
The risk of developing this disease increases with:
- immunodeficiency diseases;
- stressful situations for a long time;
- respiratory infections;
- oncology;
- a stroke;
- brain injury.
It mainly occurs as a result of complications of herpes simplex, which is manifested by rashes in the nasal mucosa and oral cavity. Much less often, herpetic viral encephalitis develops against the background of genital.
To date, there are two hypotheses for the existence of this disease:
- the resumption of the activity of virus particles in the nerve ganglia contributes to its spread over the nerves;
- it is in a sleeping state in nerve cells, from where it reactivates.
Signs in children
Newborns can be born with this pathology with intrauterine infection from the mother. A child is born with increased intracranial pressure.
The main signs of the disease in this case are as follows:
- bulging fontanel on the skull;
- tearfulness;
- vomiting
- constant cries, aggravated by morning awakening;
- lack of appetite;
- increased irritability;
- motor anxiety.
In a newborn, in addition to the brain, other organs and systems of the body can be affected:
- spleen;
- kidneys
- lungs;
- liver.
Herpetic encephalitis can occur 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 decreases with difficulty when using antipyretic drugs;
- headaches appear;
- convulsions occur throughout the body, which are difficult to stop with medications;
- thought processes are disturbed, the patient's behavior changes;
- there is a violation of the sense of reality, which can contribute to the occurrence of coma or hearing loss;
- neurological disorders are noted.
Some symptoms in adults of herpetic encephalitis do not appear in all cases and are individual in nature. These include:
- the appearance of double vision or an oblique look;
- nervous agitation;
- tachycardia;
- increase in blood pressure;
- violation of movements;
- speech distortion;
- limb paralysis on one side;
- memory losses;
- hyperhidrosis;
- the appearance of hallucinations, indicating a failure in the central nervous system, requiring immediate treatment.
Sluggish pathology
In relation to the disease in question, its sluggish form is isolated. In this case, 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 brain damage. The following symptoms are noted in patients:
- muscle dystonia;
- reflex asymmetry;
- unilateral paralysis;
- short cramps.
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
In general, infection with herpetic encephalitis is carried out by airborne droplets, therefore, the set of preventive measures generally coincides with those for colds, and also includes general recommendations for preventing genital infections:
- increase immunity;
- protected sex using condoms;
- preventing contact with patients and carriers of the virus;
- multivitamin intake.
It must be understood that this pathology is dangerous and can lead to irreversible brain dynamics and human death.
Diagnostics
It is carried out by conducting CT and MRI of the brain. The type of pathogen is determined by analysis of cerebrospinal fluid and blood using PCR. But the number of antibodies in them increases only 10 days after infection, therefore this method is used only to confirm the diagnosis and the appropriateness of the therapy.
A brain biopsy is also prescribed . In addition, cerebrospinal fluid examinations can be carried out and, as a retrospective form of diagnosis, serological reactions.
It is most important to undergo an MRI or CT scan as soon as possible, since 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.
At the end of the examination, various diagnoses can be made:
- cerebral vasculitis;
- viral encephalitis;
- toxic type encephalopathy;
- acute disseminated encephalomyelitis.
Treatment
The patient is placed in intensive care or intensive care unit to prevent the development of dysgraphia and respiratory disorders. Treatment of herpetic encephalitis is carried out with such drugs as:
- Zovirax
- "Virolex";
- "Acyclovir."
They can be used for oral administration or in severe cases, the patient is administered by injection.
The first two days after the patient is admitted to the hospital, they are 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 severe consequences. Therapy usually lasts for 7-14 days. In the hospital, the body detoxifies, restoring the water-salt balance.
Some doctors prescribe interferons, however, studies conducted in Europe do not show the effectiveness of these funds. With the onset of cerebral edema, corticosteroids are taken for no more than 7 days. When the patient is in a coma, lung ventilation and tracheal intubation are performed.
In addition, diuretics can 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 of the disease, nootropics can be prescribed.
Complications
The consequences of herpetic encephalitis are almost always very severe and are psychic and neurological in nature:
- decreased attention;
- memory impairment;
- paralysis;
- the appearance of apathy;
- fatigue increase;
- impaired coordination of movements;
- visual impairment;
- hearing loss;
- the appearance of dizziness and headaches;
- drowsiness;
- dementia, leading to a violation of cognitive functions (the appearance of dementia with the loss of acquired knowledge and the inability to obtain new ones);
- impaired speech coherence;
- decreased intelligence;
- falling off or a sharp decrease in tactile sensations;
- the 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 may be mild.
Young children may develop intracranial hypertension syndrome. 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 signs become pronounced, the infection has affected the brain quite deeply, the process is difficult to stop.
The prognosis of herpetic encephalitis can be positive if it was detected early and treated promptly. In the case of the launch of the disease, it is quite disappointing: the onset of adverse effects, up to the death of the patient, is possible. The most sad prognosis is when patients with herpetic brain encephalitis flow into a coma. According to statistics, only 10% of patients leave it, the rest die.
Sometimes pathology is formed very rapidly. This contributes to severe cerebral edema, 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. Very rarely, a complete restoration of human health is observed.
Finally
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 can remain disabled, get minor complications when treatment is started on time, or die with late or incorrect diagnosis. Prevention is mainly to increase the body's immunity.