Herpes simplex virus encephalitis, also known as acute inclusion body encephalitis or acute necrotizing encephalitis, is caused by infection with herpesvirus type 1.
The disease can occur regardless of region, climate, and season, and there is no significant difference in age and gender of patients. Prior to the onset of the disease, there are usually 1 to 2 days of precursor symptoms, such as persistent high fever, headache, and vomiting. Due to the lack of obvious specificity of these symptoms, early diagnosis is difficult.
After a few days, brain dysfunction occurs, such as coma, lethargy, impairment of emotional thinking and intelligence, accompanied by hemiplegia, ocular muscle paralysis, seizures, and other stroke manifestations. About 25% of patients develop herpes around the lips. The mortality rate of the disease is about 75%, so active treatment should be initiated once diagnosed, otherwise the prognosis is poor.
Although the disease has a high mortality rate and poor prognosis, active treatment is still necessary. The treatment method first involves hormonal therapy, with hydrocortisone or dexamethasone administered in large doses via intravenous drip for 3 to 5 days, then gradually reduced orally for 1 to 2 months. Antiviral therapy includes valacyclovir (IDU or IUDR) at a dose of 50-60mg/kg body weight per day, with a maximum dose of 100mg/kg body weight per day.
The course of treatment is 3 to 5 days, with a total dose not exceeding 20g via intravenous drip. Alternatively, cytarabine (Ara-c) can be used at a dose of 4mg/kg body weight per day, increased to 8mg/kg body weight per day after two days, for a total of 6 days, with a total dose of 42mg/kg body weight via intravenous drip. It is also important to note the use of various supportive therapies, such as fever reduction, anticonvulsants, dehydration, and reducing intracranial pressure.
