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  • Title: Progression of MRI abnormalities in herpes simplex encephalitis despite clinical improvement: natural history or disease progression?
    Author: Gaviani P, Leone M, Mula M, Naldi P, Macchiarulo E, Brustia D, Monaco F.
    Journal: Neurol Sci; 2004 Jun; 25(2):104-7. PubMed ID: 15221631.
    Abstract:
    Herpes simplex virus encephalitis (HSVE) is associated with a high mortality rate and a high probability of neurological sequelae. Good results are obtained when HSVE is promptly diagnosed and treated with acyclovir. We present a 71-year-old woman with clinically diagnosed HSVE, confirmed by PCR detection of HSV-1 DNA in the cerebrospinal fluid. She was treated with acyclovir (30 mg/kg day) for two weeks. Clinical and neuropsychological assessments 6 months after admission were normal; however MRI at 2, 6 and 12 months showed progressive deterioration with extensive white matter and cortical damage. Imaging studies of a cohort of patients surviving PCR-confirmed HSVE are needed to determine whether this pattern is occasional or a frequent form of progression.
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