Herpes simplex encephalitis is caused by herpes simplex virus 1 and 2; mainly affects the temporal lobe of the brain and present acutely along with focal neurological findings.
Presents with fever, vomiting, headache, behavioral changes (e.g. hypomania, Klüver-Bucy syndrome), convulsions, and amnesia.
Diagnosis:-
1. CSF analysis shows elevated WBC (particularly lymphocytes i.e. lymphocytic pleocytosis), elevated protein, elevated RBCs and normal glucose.
2. PCR analysis of CSF shows DNA of HSV.
3. CT scan shows hypodense lesions, hemorrhage, and edema in the temporal lobe (usually normal in 50% of the patients).
4. MRI shows hypodense lesions on T1 and hyperintense lesions on T2 and FLAIR images in the temporal lobe.
Management:-
1. Intravenous acyclovir is the treatment of choice.
2. Symptomatic measures.
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