Which physical findings are characteristic of herpes simplex virus (HSV) infections of the CNS?

Updated: Feb 27, 2019
  • Author: J Michael Klatte, MD; Chief Editor: Russell W Steele, MD  more...
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Answer

Disease occurs in those aged 5-30 years and older than 50 years.

Patients typically have malaise, irritability, and nonspecific symptoms lasting 1-7 days followed by acute onset of fever and focal neurologic signs. [54]

CSF analysis reveals pleocytosis with lymphocytic predominance. In the past, increased RBCs in the CSF were considered suggestive of CNS infection; however, with earlier recognition and diagnosis that laboratory finding is rare today. [11]

Electroencephalography may demonstrate paroxysmal lateralizing epileptiform discharges (PLEDs) but more commonly shows focal spike and slow-wave abnormalities.

Edema with hemorrhagic necrosis is observed on MRI of the brain.


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