Can herpes affect the cerebral cortex. Causes and treatment of herpetic encephalitis. Herpetic brain infection

Herpes brain is a dangerous viral pathology that leads to meningitis.

Most often, the disease occurs in young people and children, occurring in a severe form that requires immediate treatment measures. Inflammation of the meninges is accompanied by vivid symptoms.

Symptoms of herpes brain

Signs of herpes development in the brain:

• headache, which intensifies as the pathology develops;
• the occurrence of seizures that are not amenable to drug treatment;
• increase in body temperature to 39-40°C;
• confusion;
• double vision;
• pain when trying to move the eyeballs;
• weakness in the limbs;
• unsteady gait;
• hallucinations;
• memory losses.

When the nerve trunks of the spinal cord are damaged, loss of sensation in the limbs may occur.

Reasons for appearance

The process of reactivation of the herpes virus can provoke a weakened immune system. The main provoking factor in the development of the disease is HSV-1, which penetrates the human body. The herpes simplex virus is activated only under favorable conditions, the main one being the presence of a chronic focus of infection that undermines the functioning of the immune system.

Diagnosis and treatment

It is difficult to differentiate the disease from other CNS lesions. For these purposes, the following types of research are used:

• PCR. Allows you to identify the herpes virus by determining its DNA. This method is considered the most reliable;
• MRI. Magnetic resonance imaging shows the slightest structural changes in the brain, which is also of great diagnostic importance for the doctor;
• Blood and urine analysis. With meningitis, the normal values ​​of ESR and leukocytes change.

Therapy for young children and newborns requires urgent hospitalization, as the disease can lead to serious consequences. Drugs used for treatment:

• Antiviral. They influence the cause of the pathology. By suppressing the activity of herpes, they help restore normal functioning of the immune system. Such drugs are also used to prevent relapse.
• Antipyretic. Allows you to reduce high fever, improving overall well-being.
• Nootropic. Helps restore blood circulation in the brain and improve the condition of the central nervous system.
• Anticonvulsants. They allow you to relax your muscles, eliminating their uncontrolled contraction.

At the rehabilitation stage, B vitamins are often prescribed to improve the condition of the nervous system. During treatment, it is important to provide the patient with peace and absence of harsh sounds. If swelling and rash occur, antihistamines and diuretics are additionally prescribed.

Complications and consequences

Herpes in the brain can cause dangerous consequences, including death. The prognosis with a timely approach to treatment is favorable. Complications that occur most often.

Herpes brain is a disease that occurs as a result of penetration of the herpes virus under the meninges. In most cases, brain damage is caused by the form that causes rashes on the lips; in 5% of cases it causes genital herpes.

Children under 5 years of age, as well as older people (after 55), are most often affected. This is due to a decrease in immune resistance. The first category is characterized by the occurrence of a primary infection, but in adults there is activation of a virus that has been “sleeping” in the body for a long time.

Clinical picture

Symptoms of herpes brain begin to appear against the background of other diseases: external herpes, pharyngitis, stomatitis and other respiratory lesions. The clinical picture begins acutely. The medulla quickly swells and becomes inflamed, cells die and areas of necrosis form. Damage to brain tissue is of various types:

1. Diffuse: the entire brain or a large area of ​​it is involved in the process. This pathology is typical for young children.
2. Focal: a limited part of the brain is affected.

The pathological process involves gray and white matter. Often the inflammation spreads to the cerebral cortex.

The main symptoms of herpetic encephalitis:

• fever with a significant increase in temperature, sometimes up to 41 degrees;
• Jacksonian seizures - convulsive muscle contractions that begin on one side, but soon cover the entire body;
• nausea, vomiting that does not bring relief;
• paralysis and paresis;
• inability to normally control body movements (see);
• unbearable headaches that are difficult to respond to medications;
• the appearance of delusional states, aggressiveness.

If the course of the disease is very severe, or in the case where no treatment has been carried out, the pathological process spreads to the spinal cord. Symptoms of damage to the latter appear.

The mechanism of development and causes of pathology.

Learn about the symptoms and consequences of the disease.

Symptoms of brain herpes in young children are more severe than in adult patients. Often in the first phase, depression of consciousness quickly occurs, the child falls into a state from which it is difficult to get him out. The negative effect of infection on the brain manifests itself in the form of convulsions of the whole body, up to opisthotonus.

Seizures are very difficult to stop. And even if the child can be brought back to consciousness, there is a high risk of developing problems with written and spoken speech, and some motor skills may be lost. In such patients, memory almost always suffers, especially short-term memory.

Chronic encephalitis

Chronic damage is characterized by sluggish development of pathology. The disease can develop for months without making itself felt. The only symptoms that indicate the disease are periodic increases in temperature to low-grade fever (37-38 degrees), weight loss, weakness, and drowsiness.

The asthenic state is manifested by quickly onset fatigue, headaches, and decreased performance. After approximately 6–8 months, the clinical picture begins to develop and the following symptoms appear:

• muscle dystonia – too much tension or, conversely, hypotonicity;
• transient paralysis, which is often localized only on one part of the body;
• short-term seizures;
• differences in reflexes on different sides of the body.

Unlike the acute course, chronic encephalitis does not cause disturbances in the consciousness and psyche of a person. Exceptions are advanced cases when there is deep damage to brain tissue.

Diagnostics

To make an accurate diagnosis, a series of examinations are performed on the patient. To exclude traumatic or oncological causes, the following methods are used:

• Magnetic resonance imaging;
• rheoencephalography;
• CT scan.

If more than 10 days have passed since infection, cerebrospinal fluid or blood tests are prescribed, which reveal an increase in the titer of antibodies to the herpes virus. Sometimes doctors prescribe a biopsy of the affected area of ​​the brain. But since this method is associated with enormous risks, it is performed extremely rarely.

Treatment of pathology

First of all, you need to get rid of the cause, that is, the virus. For this purpose, Acyclovir is prescribed. In the first 5-7 days, large doses of the drug are administered to quickly suppress the activity of the virus, then a maintenance dosage is prescribed to prevent relapses. In addition, antiviral drugs such as Cycloferon or the like are used for treatment.

All patients require symptomatic therapy:

• to relieve swelling of the medulla, diuretics (Lasix, Furosemide, Mannitol) and glucocorticosteroid drugs (Hydrocortisone, Prednisolone) are prescribed;
• in case of problems with respiratory function, the patient is transferred to a special device that performs artificial ventilation of the lungs;
• To prevent attacks of aggression and overexcitation, the patient is sedated using Relanium, Aminazine or similar agents.

Learn about in children and newborns.

Read what it leads to: symptoms and treatment, complications of pathology.

All about: symptoms, treatment and complications. How do children become infected with meningococcus?

Disease prognosis

Herpes brain is an extremely dangerous pathology that leads to serious consequences and death. The disease is especially difficult for young children and the elderly. To avoid complications, you need to be careful about your health and consult a doctor on time. In the case of herpetic encephalitis, treatment started at the onset of the disease is the key to successful recovery.

Herpetic encephalitis is an acute inflammation of the white and gray matter of the head caused by the herpes simplex virus types 1, 2. Among the various forms of encephalitis, herpetic encephalitis is the most common and severe, both in its course and in treatment.

Herpevirus is a DNA virus. About 80% of people are infected with this virus, which manifests itself as papular rashes on the mucous membranes of the lips, nose, eyes, genitals and skin. But, in some cases, more often in people with reduced immunity, herpes affects the brain surface. Children, old people, people with immunodeficiencies are at risk.

The incidence may also be seasonal.. Researchers note that in spring and autumn, the incidence of gray matter herpes increases, which is associated with the body’s overall resistance, which decreases during these periods.

Mechanism of disease development

Scientists identify two ways of developing herpetic encephalitis:

• The first is primary infection. The herpevirus enters the mucous membrane of the nose or mouth, and, since it is tropic for nervous tissue, penetrates the axons of the smelling nerves, from where it spreads throughout the nervous system - into the nerve ganglia and the brain.
• The second is the activation of the virus. In carriers, due to decreased immunity (stress, trauma, poor nutrition, diseases that cause immunodeficiency - tuberculosis, rheumatism, cancer, AIDS), the virus becomes active and affects the tissue of the cerebral convolutions, namely the lower part of the frontal lobe and the temporal lobe. Cell damage is accompanied by swelling, inflammation, and cell death.

Symptoms

Common characteristic features are:

• acute respiratory infection with herpetic rashes suffered the day before;
• acute increase in body temperature to 39 degrees and above, which is difficult to treat;
• disturbances of consciousness of varying severity - from general lethargy to coma;
• convulsions of the whole body or parts of it.

All other symptoms are purely individual, as they depend on which area is affected.

It can be:

• various paresis;
• speech disorders;
• auditory or visual hallucinations;
• confusion;
• epileptic seizures;
• violation of autonomic functions, up to cardiac arrest;
• headache.

Diagnostics

The diagnosis of herpetic encephalitis can be made on the basis of clinical data in combination with laboratory and instrumental studies.

Spinal puncture and analysis of cerebrospinal fluid for viral DNA is a mandatory research method. Using polymerase chain reaction (PCR), identifying the virus is simple and quick. Computed tomography or nuclear magnetic resonance imaging is also prescribed, which allows identifying foci of tissue necrosis in the brain. The disadvantage of this study is that in the first stages of the disease there are no structural changes in the organ; they appear on the 4-5th day of the disease.

A biopsy and examination of the biopsy sample for the presence of a virus are quite informative, but due to the traumatic nature of the method and the high risk of complications, it is rarely used.

Herpes brain is an extremely dangerous pathology, characterized by inflammation of the gray and white matter as a result of tissue damage by the herpes simplex virus types 1 and 2. This disease is acute and is accompanied by disorders that are extremely difficult to correct in the future.

Herpes brain is an extremely dangerous pathology, characterized by inflammation of the gray and white matter as a result of tissue damage by the herpes simplex virus types 1 and 2.

A special risk group for developing this pathological condition includes newborn children and the elderly. In addition, herpes brain damage is often observed in those who suffer from immunodeficiency.

Symptoms of herpes brain

Herpetic tissue damage manifests itself with acute symptoms. After suffering an acute period of herpes, accompanied by rashes, the pathology does not enter a latent period. The latent course of herpes brain lesions can be observed from 2 to 20 days.

Subsequently, the patient experiences a process of virus reactivation. Because of this, the body temperature rises sharply above +39°C, and it is difficult to reduce it with medications.

Both adults and young children experience disturbances of consciousness of varying severity.

If the course is unfavorable, coma is possible. In addition, the following signs of damage to the brain and spinal cord may appear:

• convulsions;
• disturbances in the sensitivity of individual parts of the body;
• visual and auditory hallucinations;
• epileptic seizures;
• Strong headache;
• unsteadiness of gait;
• memory loss;
• increased sweating;
• excited state;
• vegetative disorders.

Depending on the form and severity of damage to the nerve trunks by herpes, the duration of the increase in acute symptoms can vary from several days to a week or more. The patient's condition becomes extremely serious.

Reasons for appearance

Damage to brain structures by the herpes virus is rare. The following can contribute to the activation of the virus and the appearance of this pathology:

• reduced immunity due to AIDS;
• exhaustion;
• severe vitamin deficiency;
• hypothermia;
• tuberculosis;
• rheumatism.

The influence of these unfavorable factors causes a decrease in immunity. The body's defense mechanisms cannot suppress the virus. Once it enters the human body, herpes can no longer be completely eliminated, but if the immune system is in a normal state, the virus remains latent.

Diagnosis and treatment

The characteristic clinical picture and data from instrumental and laboratory examinations allow an accurate diagnosis. To determine the problem, the following are assigned:

• cerebrospinal fluid puncture;
• biopsy;
• general and biochemical blood tests.

Therapy should be carried out in a hospital setting. The patient requires intensive drug treatment. First of all, antiviral drugs are prescribed, including:

• Gerpevir;
• Acyclovir (more details);
• Virolex;
• Zovirax (more details).

The form and dosage of these medications are prescribed by the doctor individually. Among other things, immunomodulatory drugs, corticosteroids and interferons are prescribed to correct the functioning of the immune system.

To stabilize the condition, detoxification therapy can be performed. Medicines may be prescribed to help manage symptoms, including diuretics, anticonvulsants and antipyretics.

In most cases, the prognosis depends on the timely start of treatment.

Complications and rehabilitation

Brain herpes can have extremely adverse consequences. In this pathological condition, neurological disorders may remain after the completion of the acute course of the disease. Complications that often occur with this disease include:

• migraine;
• meningitis;
• decreased mental activity;
• muscle weakness;
• partial memory loss;
• visual, speech and hearing impairments;
• attacks of dizziness;
• epilepsy;
• various mental disorders.

If rehabilitation is not carried out properly, these complications may persist for the rest of your life. If, after eliminating acute symptoms, a person is forced to work and is mentally overtired, takes alcohol or is exposed to other unfavorable factors, the consequences of the viral damage to brain tissue may become more pronounced.

Herpetic encephalitis

– extremely dangerous damage to brain tissue by the herpes virus. In the absence of targeted treatment, death occurs in approximately 80% of cases. Timely seeking medical help prevents the development of severe complications that will persist for a long time. To reduce the risk of encephalitis caused by herpes, it is necessary to maintain a high level of immunity: eat right, exercise regularly, and give up all bad habits.

Herpetic brain damage is a necrotic process, therefore, after the disease, there is a high probability of developing neurological complications, both temporary and permanent.

Herpetic brain damage is a necrotic process, therefore, after the disease, there is a high probability of developing neurological consequences - both temporary and permanent.

With herpes infection, damage to the central nervous system most often occurs in the form of encephalitis (inflammation of the brain) or meningoencephalitis (inflammation of the brain and its membranes). The form of the disease can be localized, or it can be combined with damage to the skin, mucous membranes and internal organs, i.e., be one of the syndromes of a generalized process. The most vulnerable category of patients are newborns and young children.

Herpetic encephalitis

Herpetic encephalitis is one of the most common encephalitis. In approximately 2/3 of patients, the impetus for the development of the disease can be a previously dormant and suddenly “awakened” infection that already exists in the brain. This occurs under the influence of injury, the action of drugs (for example, glucocorticosteroids), hypothermia or overheating, etc. The remaining third of patients also have exogenous, i.e., originating from external causes, infection.

The herpes virus enters the central nervous system through the blood, but the main route of spread is along the nerve trunks (mainly along the branches of the trigeminal nerve and the olfactory tract). Next, the virus enters the subcortical nuclei, the nuclei of the brainstem, reaches the cerebral cortex, and in most cases the midbrain, brainstem and hemispheres are captured.

Symptoms

Herpetic encephalitis is characterized by the same syndromes as encephalitis in general: the syndrome of impaired consciousness, hyperthermic, convulsive syndromes and the syndrome of focal disorders.

Herpetic encephalitis begins acutely, usually after one to two days of acute respiratory infection. The temperature suddenly rises, usually above 39 0 C, which is difficult to bring down. Consciousness is disturbed: short-term (within a few hours) excitement is replaced by lethargy, drowsiness, lethargy until it is completely lost and deeply depressed - up to varying degrees of coma. Consciousness returns gradually.

Since herpetic encephalitis often affects the frontal lobes of the brain, the child’s memory, written and oral speech skills are impaired, children forget how to read, draw, etc. The child’s behavior and his attitude towards others may change. All these are manifestations of the syndrome of focal disorders.

Persistent convulsive syndrome (epileptic seizures), also characteristic of herpetic encephalitis, is generalized and difficult to stop even with the most modern means.

Treatment and prognosis

Today, timely antiviral therapy has reduced mortality to 5-6% (before the advent of acyclovir it reached 74%). With a favorable course of the disease, from the 3-4th week the stage of reverse development of symptoms begins, which lasts from three months to six months or more. In the future, long-term active rehabilitation therapy is required.

In adults, herpetic encephalitis can become chronic. In this case, intellectual-mnestic disorders progress up to dementia (dementia). A “mild” version of chronic herpetic encephalitis in the form of chronic fatigue syndrome is possible.

Herpetic meningitis

When the central nervous system is damaged by the herpes virus against the background of encephalitis, meningoencephalitis, which is caused by herpes simplex virus types 1 and 2, can develop. Herpetic meningitis in the structure of serous meningitis is 4-8%. As a rule, the disease begins acutely.

Symptoms

As with any meningitis, with meningoencephalitis there is an increasing persistent headache - diffuse or localized in the frontotemporal region; repeated vomiting not associated with food intake. Often the first manifestations of meningitis are preceded by signs of acute respiratory viral infection; characteristic rashes appear on the skin and mucous membranes. After about three days, symptoms of cerebral edema appear: impaired consciousness in the form of confusion, lack of orientation in time and space. Patients often become aggressive, they develop visual and auditory hallucinations, local or generalized convulsions.

Treatment and prognosis

The course of meningitis is acute. With timely antiviral therapy, body temperature normalizes within a week, headaches and meningeal symptoms disappear. In extremely severe forms of meningoencephalitis, death is possible.

Meningoencephalomyelitis

With herpetic infection, combined damage to the brain and spinal cord occurs - meningoencephalomyelitis. Along with the signs of herpetic meningoencephalitis, clinical signs of myelitis appear.

Symptoms

The disease begins acutely or subacutely against the background of general infectious symptoms: fever up to 38-39 °C, chills, malaise. Neurological manifestations begin with moderate pain and paresthesia in the lower extremities, back and chest, which are radicular in nature. Then, within one to three days, motor, sensory and pelvic disorders appear, increase and reach a maximum: paralysis of both lower extremities (paraplegia), true incontinence or retention of urine and feces, etc. When the phrenic nerve is damaged, breathing disorders occur. In more rare cases, the inflammatory process affects only half of the spinal cord.

Treatment and prognosis

For this disease, broad-spectrum antibiotics in maximum doses, glucocorticosteroids, B vitamins and other drugs are prescribed.

The disease very rarely goes away without a trace; with severe damage to the diameter of the brain after meningoencephalomyelitis, persistent paraplegia remains. More often, even if movement is restored, there remains an element of spasticity in the gait, paresthesia, and leg cramps.