Herpes simplex encephalitis: clinical presentation, neurological sequelae and new prognostic factors. Ten years of experience

Neurol Sci. 2013 Oct;34(10):1879-81. doi: 10.1007/s10072-013-1475-9. Epub 2013 Jun 19.


Herpes simplex encephalitis (HSE) is the most important viral encephalitis due to its high mortality and neurological sequelae. The aim of this study was to contribute to better characterise the HSE. We retrospectively analysed patients with a diagnosis of HSE in our hospital during 2000 and 2010. We included those patients who had a positive result for PCR for herpes simplex virus in cerebrospinal fluid and those with a negative result presenting with a consistent clinical and neuroimage profile. We included 26 patients (10 men, 16 women). Mean age was 58 years. Most frequent symptoms at admission were fever, confusion, aphasia and seizures. Mortality rate was 11 %. 2 patients presented a clinical relapse. In conclusion, the most frequent neurological sequelae were aphasia and amnesia. Disorientation, hyponatremia and abnormalities in initial brain CT were identified as new prognostic factors.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Central Nervous System / physiopathology*
  • Central Nervous System / virology*
  • Disease Progression
  • Electroencephalography
  • Encephalitis, Herpes Simplex* / diagnosis
  • Encephalitis, Herpes Simplex* / physiopathology
  • Encephalitis, Herpes Simplex* / therapy
  • Female
  • Humans
  • Longitudinal Studies
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Retrospective Studies
  • Simplexvirus / genetics
  • Tomography Scanners, X-Ray Computed
  • Young Adult