The symptoms of herpes encephalitis can be understood in different periods

Herpes encephalitis is a common clinical disease. Generally speaking, after people suffer from herpes encephalitis, they should learn more about the symptoms of the disease. So, what are the symptoms of herpes encephalitis?

1. Prodromal stage

Symptoms include dizziness, headache, body pain, etc., followed by symptoms of upper respiratory tract infection, and fever can reach 38-40℃. Only some cases have skin herpes. This period usually does not exceed 2 weeks.

2. Neuropsychiatric symptoms

Its manifestations vary. In the early stages, mental symptoms are often prominent, including personality changes, abnormal behavior, irrelevant answers, disorientation, hallucinations, delusions, amnesia, and aphasia, which may be caused by the early invasion of the temporal lobe, frontal lobe, and limbic system by the virus through the trigeminal nerve and olfactory bulb.

As the disease progresses, necrotic foci appear in brain tissue and patients show impaired consciousness. For example, drowsiness, lethargy, delirium, coma, etc.; convulsions, twitching, hemiplegia and cranial nerve dysfunction such as strabismus, anisocoria, hemianopsia, etc., accompanied by manifestations of intracranial hypertension. The patient has a stiff neck, increased muscle tone, and pathological reflexes. Some cases present with decerebrate rigidity in the early stages. In severe cases, brain herniation may occur.

Acute encephalomyelitis mainly occurs in infants under 1 year old, who are infected through the HSV-infected birth canal during birth. Intrauterine infection can cause diffuse brain damage or malformations.

EEG abnormalities may appear in the early stages of the disease. Typical changes are focal periodic sharp waves on a diffuse high-amplitude slow wave background; the temporal lobe and frontal lobe often show periodic spikes and slow waves. Brain CT and MRI examinations can show low-density lesions in the temporal and frontal lobes, accompanied by punctate hemorrhages and cerebral edema, and ventricular compression and displacement can be seen. Radionuclide brain scan showed increased uptake in the temporal and frontal lobes.