HSE Complications
Seizures are common and some authors recommend prophylactic anti-seizure therapy in patients with severe HSE. Brain edema that occurs sometimes can be resolved with steroid therapy, although the use of steroids in the HSE is still a controversy. Adjunct therapy for brain edema include hyperventilation and barbiturates. Other complications that looks similar to all patients and patients with severe pain severe consciousness disturbance (eg, aspiration pneumonia, venous thrombosis profundus, and decubitus.)
Seizures are common and some authors recommend prophylactic anti-seizure therapy in patients with severe HSE. Brain edema that occurs sometimes can be resolved with steroid therapy, although the use of steroids in the HSE is still a controversy. Adjunct therapy for brain edema include hyperventilation and barbiturates. Other complications that looks similar to all patients and patients with severe pain severe consciousness disturbance (eg, aspiration pneumonia, venous thrombosis profundus, and decubitus.)
HSE Prognosis
The death rate by about 19% Acyclovir therapy. Sequelae significantly depending on age and neurological status of patients when the diagnosis is established. Patients with coma at the time of diagnosis have a poorer prognosis regardless of age. Patients with nonkomatous consciousness, the prognosis depends on age with a better prognosis if age <30 years. Neurological status of patients who survive include: 46% without a deficit or a very mild deficit, the deficit was 12% and 42% had severe deficits. An estimated 5-10% of patients who survive will experience relapse within a few days to several weeks after therapy is completed. In some patients, recurrence due to reactivation of the virus, while others are caused by immune-mediated encephalitis after infection
Delayed treatment:
Failure diagnosis or suspected diagnosis of HSE cause a delay of therapy with the risk of increased mortality or morbidity. This caused no clinical picture depicting patognomonis HSE. If the source of infection can not be identified, HSE should be considered in every patient with a hot body and encephalopathy, focal neurological symptoms or CSF pleocytosis on examination. Consideration of acyclovir empirically delayed until confirmation of the diagnosis made.
In people with immune system impairment, early phase clinical appearance may be mild or non-specific (HIV, steroid therapy). Focal neurological deficit, pleocytosis in CSF and CT scan may not look abnormal on the initial phase. PCR results are positive and abnormalities on MRI always obtained in these cases.