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Step back in time: How to reverse the fate of herpes encephalitis in 48 hours?
Herpes encephalitis (HSE) affects approximately 1 in 500,000 people each year. This life-threatening disease often stems from an infection called herpes simplex virus (HSV), specifically HSV-1. Although most people infected with the virus will not experience obvious symptoms, once the virus enters the brain through the nervous system, it can cause irreversible damage. Therefore, prompt diagnosis and early treatment are crucial in saving lives and reducing neurological damage.
There are an estimated 2 to 4 cases of herpes encephalitis per million people per year.
Symptoms and diagnosis of herpetic encephalitis
Many people display reduced levels of consciousness and altered mental states after being infected with HSE, with symptoms including confusion and personality changes. Additionally, patients will experience an increased number of white blood cells in their cerebrospinal fluid without the presence of pathogenic bacteria or fungi. Patients are often accompanied by symptoms such as fever and convulsions.
Because brain wave activity will show abnormalities after the onset of symptoms, CT or MRI examination will show characteristic changes in the temporal lobe of the brain. What's more, confirming the diagnosis requires a lumbar puncture to detect the virus in the cerebrospinal fluid. While awaiting results, suspected cases should be treated immediately with acyclovir.
If not treated promptly, about 70% of HSE cases will die quickly, and survivors will suffer severe neurological damage.
Treatment methods and challenges
The main treatment for HSE is high-dose intravenous injection of acyclovir. The time window for initial treatment is very important and usually needs to be carried out within 48 hours after the first symptoms appear. Early intervention can significantly improve the chances of recovery, but even then, one in three cases will still be fatal.
Of those who have been treated, more than half of survivors will experience long-term neurological damage. Only a minority of patients (about 20%) recover well with only minor damage. There are also some reports in the literature that some untreated survivors (2.5%) can regain normal brain function.
Risks and complications
Even with treatment, patients may experience recurrence of the infection weeks to months later. In addition, HSE can also serve as a stimulus to trigger an immune response of anti-NMDA receptor encephalitis, which causes obstacles to neurocognitive recovery. About 30% of HSE patients will encounter this complication.
Early treatment (within 48 hours after symptoms begin) improves the chances of a good recovery.
Epidemiological status quo
The incidence of herpetic encephalitis is about 2 to 4 cases per million people per year, but the proportion of patients increases with age. Although most causes of HSE are related to HSV-1, HSV-2-related encephalitis is more common in neonates and immunocompromised individuals.
This study reminds us of the need for early identification and rapid treatment. All sectors of society urgently need to have a deeper understanding of this disease to reduce its serious consequences. So we should consider: What can we do to protect ourselves and others when faced with this potentially deadly viral infection?
