Herpes of the brain is an infectious inflammation of a cerebral of viral origin. In medical nosology, the disease is called herpetic encephalitis. The disease is manifested by general-selling symptoms and specific features that are characteristics for a simple herpes virus. Infection affects not only the brain, but also other departments nervous system.

People from 5-30 years old are most often a virus damage to the brain and after 50. Seasonality is not peculiar.

The disease occurs in two forms:

1. Asymptomatic virus carriage. Herpes does not show itself due to the containment of its immune system. The patient still remains a potential source of infection when contacting other people (transmission paths - through mucous membranes and skin). There are no symptoms with latent virusism.
2. The manifest form of the virus. Character typical clinical picture for herpetic inflammation of the brain.

For herpetic encephalitis, high mortality and severe flow is characteristic. Possible outcomes of the disease:

• dementia is early dementia;
• death;
• apallicic syndrome is a comatose state in which a person is in "Consciousness", but does not participate in the world around the world and loses all cognitive functions.

With timely diagnosis and treatment of the consequences, avoids and the patient returns to the former lifestyle.

Causes and pathogenesis

Herpety encephalitis excites herpes virus 1 or 2 types. The virus itself, in the inside of the nervous cell, does not kill it. On the contrary, the neuron depresses the virus and does not give it to multiply. Herpes manifests itself when the immune system A person, as a result of lowering protective functions of factors, is weakened. To such factors belongs:

• stress;
• bad food;
• lacking;
• bad habits and dependencies;
• passive lifestyle.

Herpes Virus penetrates the brain on nervous ways. For example, the infection was transferred along the mucous membrane of the mouth and was transported from there in the mucous nose. Once in favorable conditions (heat, moisture, nutrient medium), herpes for olfactory nerves are transposed in the second neuron - an olfactory bulb, in which the virus reaches the frontal and temporal fractions brain. This option is characteristic of adults.

The second way is hematogenic, blood. This type of infection is characteristic of a generated infection of newborns when the mother was a carrier of the virus.

Symptoms and diagnostics

The symptoms of herpetic encephalitis usually has a typical start and dynamics. The disease begins with a flu-like state and is manifested by the first symptoms:

1. acute increase in body temperature up to 39-40s;
2. nausea and vomiting;
3. asthenic syndrome: fatigue, apathy, irritability.

In some cases, the disease begins with cough, sneezing and cold.

For 2-3 days, characteristic signs of brain inflammation are joined:

• Violation of consciousness. "Swing": the state of the excitation, which is accounted for up to several hours, is replaced by injecting, drowsiness and apathy. In the course of the development of the ailment of the phenomenon of disturbing consciousness increase: the patient can go to whom.
• Pares. The weakening of muscle strength in the limbs occurs suddenly.
• Epileptoid states and small convulsive seizures.
• Transient mental disorders. There are short-term disorders of memory: patients with difficulty remember what is happening and not able to reproduce the events during the disease. In a clinical picture, symptoms specific for brain departments are observed:
  • akalkulia is a violation of an arithmetic account;
  • agnosia is a violation of the perception of different modality (hearing, olfactory, taste, visual);
  • apraqulica - the state of temporary loss of higher skills (work with a screwdriver, sewing skills);
  • afazia - violation of the formation and perception of speech;
  • psychotic disorders: symptoms of permanent consciousness;
  • Corsakovsky syndrome: the inability to remember the current events, disorientation in time, reproduction of fictional (from books, films) events;
  • infectious delicacy: visual real hallucinations, fear, anxiety; the patient shouts individual words not related to each other; inadequate behavior; complains that he sees fantastic animals who are trying to kill him;

The disease is diagnosed based on a clinical picture, laboratory diagnostics and instrumental methods. The latter refers and. They help to exclude other brain diseases (tumors, for example).

The Gold Standard is considered PCR and lumbar puncture. The first method finds a DNA of the virus in the liquor, the second - high-quality changes of the cerebrospinal fluid (increase in protein, lymphocytes, leukocytes, the rate of folding erythrocytes and the specific gravity of the liquor).

Treatment

Therapy of herpes of the brain is carried out in the resuscitation and intensive care unit:

1. Etiotropic treatment (elimination of the cause): assigned antiviral drug - Acyclovir.
2. Removing brain edema with strong diuretic (furosemid).
3. Saving epileptic seizures: Sibazone solution.
4. Correction of water and electrolyte balance: sodium bicarbonate, Ringer's solution, sodium chloride.
5. Prevention of bacterial complications: Assigned tools that increase immunity (interferon).

Forecast

Forecast of the disease unfavorable for several reasons:

• Patients who have developed a coma dying in 70-80%.
• The syndrome of akinetic mutism is developing - a condition in which the patient cannot speak and move, although the physical opportunity for speech and movements is preserved.
• Long-term recovery stage: from two years and more patients returned mental functions.
• Rough disorder of knowledge. For example, Clever-Bewsi syndrome. It is characterized by the weakening of emotions, disruption of food behavior, hypersexuality and visual agnosia (loss of the ability to recognize objects through the visual channel of information).

Herpety encephalitis - acute inflammation The white and gray substance of the head caused by a variety of herpes type 1, 2. Among the various forms of encephalitis, herpetic is most frequent and heavy both in flow and treatment.

Herpevirus refers to DNA viruses. About 80% of people are infected with this virus, which is manifested by papulese rashes on mucous lips, nose, eyes, genital organs and skin. But, in some cases, more often in people with a reduced immunity, herpes is striking a brain surface. Children, old people, people with immunodeficiency are in the risk area.

The incidence can also be a seasonal character. Researchers note - in spring and autumn the incidence of herpes of gray substance increases, which is associated with the general resistance of the body, which is reduced to these periods.

Mechanism for the development of the disease

Scientists allocate two ways to develop herpetic encephalitis:

• The first is primary infection. Herpevirus hits the mucous membrane of the nose or mouth, and because he tropen nervous tissue, penetrates axons of snuff nerves, from where it extends throughout the nervous system - in the nerve ganglia and the brain.
• The second is the activation of the virus. The carriers due to the decrease in immunity (stress, injuries, poor nutrition, diseases causing immunodeficiency - tuberculosis, rheumatism, cancer, AIDS), the virus is activated and affects the brainstorm tissues, namely the lower part of the frontal lobe and the temporal. The damage of the cells is accompanied by edema, inflammation, their dying.

Symptoms

Common characteristic features is an:

• transferred on the eve of ARZ with herpetic rashes;
• acute body temperature increase of up to 39 degrees and above, which is seriously therapy;
• disorders of consciousness of different gravity - from the general inhibition to coma;
• full body cramps or its parts.

All other symptoms are purely individual, as it depends on which site is amazed.

It can be:

• diverse paresa;
• speech disorders;
• auditory or visual hallucinations;
• confusion of consciousness;
• epileptic seizures;
• violation vegetative functions, right up to a heart stop;
• headaches.

Diagnostics

The diagnosis of "Herpety Encephalitis" can be made on the basis of clinical data in combination with laboratory and instrumental studies.

Spinal puncture and analysis of the spinal fluid on a DNA of the virus - a mandatory research method. With the help of a polymerase chain reaction (PCR), determine the virus simply and quickly. Also prescribe computed tomography or nuclear-magnetically resonant tomography, which allows you to identify the foci of tissue necrosis in the brain. The disadvantage of this study is that in the first stages of the disease of structural changes there is no body, they appear on 4-5 days of the disease.

An informative biopsy and a biopsy study for the presence of a virus, but due to the traumatic method of the method and high risk of complications is rarely applied.

Treatment

Patients should be immediately hospitalized in the ward of intensive therapy.

There are specific therapy under herpese encephalitis - acyclovir, herpevir. Dose, reception frequency and dosage form depend on the severity of the disease and are determined by the attending physician.

Also prescribe immunomodulators and interferons, corticosteroids to significantly increase the effect of antiviral therapy at the same time apply disinfecting therapy, dehydration and symptomatic agents.

Consequences and prevention

Herpes of the brain can pass without consequences, but sometimes unwanted complications remain:

• epilepsy;
• personal and intellectual disorders;
• paraliacy and paresa.

Changes are persistent, treatment is not amenable, since they appear as a result of structural disorders in the brain. If the patients with encephalitis of herpes etiology are not treated - the fatal outcome occurs in more than 80% of cases.

Herpes of the brain is a dangerous viural pathology, leading to the appearance of meningitis.

Most often the disease is found in young and childhood, passing in severe form requiring urgent treatment measures. Inflammation brain shells accompanied by bright symptoms.

Symptoms of herpes brain

Signs of herpes development in the brain:

• headache, which, as pathology, increases strengthens;
• the occurrence of seizures that cannot be drugized;
• increase body temperature up to 39-40 ° C;
• confusion of consciousness;
• split in the eyes;
• pain when trying to move the eyeballs;
• weakness in the limbs;
• unstable gait;
• hallucinations;
• memory losses.

With damage to the nerve spinal cord, loss of sensitivity in the limbs may occur.

Causes of appearance

The process of reactivation of herpes virus can provoke loose immunity. The main provoking factor in the development of the disease is HPV-1, which penetrates the human body. Simple herpes virus is activated only under favorable conditions, the main of them is the presence of a chronic focus of infection, undermining the work of immunity.

Diagnosis and treatment

Differentiate the disease from other lesions of the CNS is difficult. For these purposes apply the following types of research:

• PCR. Allows you to identify herpes virus by defining its DNA. This method considered the most reliable;
• MRI. Magnetic resonance imaging shows the slightest structural changes in the brain, which also represents an important diagnostic value for a doctor;
• Blood and urine test. Under meningitis, normal EC and leukocyte indicators change.

The therapy of young children and newborns implies urgent hospitalization, since the disease can lead to serious consequences. Preparations that are used to treat:

• Antiviral. Influence the cause of pathology. Suppressing herpes activity, contribute to the restoration of the normal operation of the immune system. Such drugs are used to prevent recurrence.
• Antipyretic. Allow you to bring down high temperature, improving overall well-being.
• Nootropic. Contribute to restoring blood circulation in the brain, improve the state of the CNS.
• Antichesism. Allow to relax muscles, eliminating their uncontrollable reduction.

At the stage of rehabilitation, vitamins of groups B, which improve the state of the nervous system are prescribed. During treatment, it is important to ensure patient peace, the absence of sharp sounds. In the occurrence of edema and rash, antihistamines and diuretic drugs are additionally prescribed.

Complications and consequences

Herpes in the brain can provoke dangerous consequences Up to death. Forecast with a timely approach to treatment favorable. Complications that occur most often.

The herpes virus is a fairly common phenomenon. They are infected by about 85% of people living on the planet. True, in most cases, there is a virus in the human body in an inactive condition. Only with the appearance of some factors capable of affecting the reduction of the immune system of protection, herpes becomes dangerous.

Causes of manifestation and symptoms

Basically, herpes virus manifests itself in the form of a wound on the lips, mucous membranes of the eyes, nose, sometimes oral cavityas well as on skin Covers and in the field of genitals. His treatment does not cause special difficulties, because it does not take much time and strength. It is enough to apply a special ointment or gel to the affected area for 2-3 weeks, and there will be no trace of an unpleasant disease.

Sometimes to achieve due effect, it takes some time to take inside antiviral drugs. But herpes cannot be fully cured.

It remains in the human body forever, from time to time (with favorable circumstances) manifest itself.

Herpetic brain encephalitis is considered the most dangerous manifestation. it infection Causes a simple herpes virus (1 or 2 types), which provokes inflammatory process. Most often, herpes of the brain arises from people with a weak immunity. In the risk group most often children (up to 6 years), and people of old age (after 55 years).

Why the brain infection occurs with the herpes virus is definitely not known. For its development requires such factors:

1. Penetration into the body of herpes virus, which is 2 species: congenital (when the fruit is infected in the womb of the mother) and acquired (enters the body from the external environment by air-drip, sex and other paths).
2. Weakening of immunity due to certain reasons (by virtue of age, due to previously transferred disease).

Herpes virus, falling into the cells (including neurons), exists in their oppressed latent state. When the immune system is weakened, it begins to actively multiply and on the fibers of the nerves penetrates into the brain, provoking the inflammatory process in it - encephalitis.

Often, herpetic encephalitis is localized in the temporal and frontal part of the brain. It is here that the motion of the brain cells and the inflammatory process is observed.

Most characteristic symptoms for this disease are:

The emergence of such symptoms may also testify to the presence of other diseases of the central nervous system. In any case, it is necessary to consult with an experienced doctor.

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How is the treatment?

For adequate treatment, it is necessary to put the correct diagnosis. To do this, the patient must pass a number of surveys:

If the diagnosis confirmed it is necessary to immediately begin therapy, since this disease is very dangerous to human life.

Treatment is carried out exclusively in the hospital. There is a risk of a sudden respiratory stop, as well as the high probability that the patient can fall into a comatose state. In such cases, resuscitation is carried out.

The treatment of herpes of the brain is to apply medication tools that are aimed at eliminating the infectious process and related symptoms. First of all, prescribe:

Additionally, the patient with a similar diagnosis is shown a strict bed mode, proper nutrition, abundant drink. If it cannot independently use food and water, it is prescribed to the inner administration of drugs that can get rid of depletion and dehydration.

The course of treatment lasts from 5 days to 2 weeks, depending on the complexity of the disease and the general condition of the patient. A comatose state significantly reduces the chances of recovery. Only 20-30% of people come out of the coma, a fatal outcome is possible. Therefore, it is very important in time to diagnose the disease.

Risk of disease and possible complications

Herpety brain encephalitis - very serious and dangerous disease. Complete recovery after it comes quite rarely - only about 25% of people with such a diagnosis after passing the course of therapy have the opportunity to conduct a full-fledged lifestyle.

Most patients dies, not even time to begin treatment, since the disease occurs unexpectedly and develops rapidly. But this does not mean that with such a disease, death is obligatory. Early identification and proper specialized treatment can preserve the patient and life, and health.

Brain damage very rarely passes without complications. Any violation of its work and functionality leads to irreversible consequences.

Herpetic infection causes an inflammatory process that can lead to pathological conditions man:

1. Coma. It greatly complicates the treatment process. Often patients never go out of the coma.
2. Stop breathing. If the patient urgently does not reanimate, it can die.
3. Mental deviation. Brain damage is accompanied by the destruction of its cells, which leads to a deterioration of its work.
4. Mental disorders. It may be a nervous state, sleep disturbance, long-term hallucinations, dips in memory.
5. Permanent headache, which is hard to remove.
6. General deterioration of well-being, weakness, apathy, loss of performance.
7. Complete or partial hearing loss and vision.
8. Violation of speech functions.
9. Meningitis.
10. Deterioration or loss of motor activity, paralysis of the whole body or individual limbs.

The recovery of man, patient with herpetic encephalitis of the brain, it comes depending on the severity of the disease.

With the lungs of its forms, the forecast is often favorable, and the course of therapy lasts no more than a month. Treatment of the launched stage and heavy forms stretches for years.

There are factors that may affect the course of the disease, as well as provoke relapses:

• incorrect or late treatment;
• pregnancy;
• stress, mental exhaustion;
• persistent overwork of the body due to physical exertion;
• eating alcoholic beverages, harmful food.

In any case, herpetic encephalitis of the brain is not a deadly sentence. Timely diagnosis I. proper treatment Under the supervision of an experienced specialist give positive results. The main thing is not to panic and do not engage in self-medication.

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The herpetic lesion of the brain is a necrotic process, therefore, after a transferred disease, the likelihood of the development of neurological complications of both temporary and permanent characteristics is high.

The herpetic lesion of the brain is a necrotic process, therefore, after the suffering disease, the likelihood of the development of neurological consequences is high - both temporary and permanent nature.

In herpetic infection, the defeat of the central nervous system often proceeds in the form of encephalitis (brain inflammation) or meningoencephalitis (inflammation of the brain cerebral of his shells). The form of the disease can be localized, and can be combined with damage to the skin, mucous membranes and internal organs, i.e. to be one of the syndromes of the generalized process. The most vulnerable category of patients is newborns and young children.

Herpety encephalitis

Herpety encephalitis is one of the most common encephalitis. Approximately 2/3 patients with the impetus for the development of the disease can be dormant to this and suddenly "woken up" infection already existing in the brain. This happens under the influence of injuries, actions medicines (for example, glucocorticosteroids), supercooling or overheating, etc. The remaining third of patients and with an exogenous, i.e. that originates from external reasons, infection.

The herpes virus penetrates the CNS through blood, but the main path of distribution is along the nerve trunks (mainly according to the branches trigeny nerve and the olfactory tract). Next, the virus falls into the subcortical nuclei, the core of the trunk, reaches the cortex of the brain and in most cases the middle brain, trunk and hemispheres of the brain are captured.

Symptoms

For herpetic encephalitis, the same syndromes are characterized as for encephalitis in general: disruption syndrome, hyperthermic, convulsive syndromes and focal disorders syndrome.

Herpety encephalitis begins acutely, usually after one or two days of acute respiratory infection. Suddenly the temperature increases, as a rule, above 39 0 s, which is difficult to knock down. Consciousness is disturbed: the excitement is short-lived (for several hours), the excitement is replaced by the inhibition, drowsiness, lethargy to its full loss and deep oppression - up to coma of varying degrees. Consciousness returns gradually.

Since under herpetic encephalitis, the frontal shares of the brain are often amazed, the child has a memory, writing skills and oral speech, children are learning to read, draw, etc. The behavior of a child may change, his attitude towards others. All this is the manifestations of focal disorders syndrome.

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

Treatment and forecast

Today, antiviral therapy has launched a timely launched to 5-6% (before the advent of aciclovir, it reached 74%). With a favorable course of the disease from the 3-4th week, the stage of reverse development of symptoms, which continues from three months to six months and more. In the future, long-term active recovery therapy is required.

In adults, herpetic encephalitis can go to chronic form. In this case, intellectual-insicurative disorders are progressing up to dementia (dementia). Possible "soft" variant of chronic herpes encephalitis in the form of chronic fatigue syndrome.

Herpety meningitis

With the damage to the central nervous system, the herpes virus against the background of encephalitis can develop meningoencephalitis, which is caused by a variety of herpes 1 and 2 types. Herpety meningitis in the structure of serous meningitis is 4-8%. As a rule, the disease begins sharply.

Symptoms

As with any meningitis, with meningoencephalitis, an increasing resistant headache is observed - diffuse or with localization in the front-desk; Not related to meals multiple vomiting. Often, the first manifestations of meningitis are preceded by signs of ARVI, characteristic rashes on the skin and mucous membranes appear. After about three days, symptoms of brain edema appear: a violation of consciousness in the form of confusion, the lack of orientation in time and space. Patients are often aggressive, they appear visual, auditory hallucinations, local or generalized convulsions.

Treatment and forecast

The course of meningitis is sharp. With a timely initiated antiviral therapy, the body temperature is normalized during the week, headaches disappear and meningheal symptoms. With the extremely severe forms of meningoencephalitis, death is possible.

Meningoencefalomyelitis

In herpetic infection, a combined lesion of the head and spinal cord is found - meningoencefalomyelitis. Along with the signs of herpetic meningoencephalitis, manifest clinical signs Melita.

Symptoms

The disease begins acutely or undercoins against the background of general-infectious symptoms: increase temperatures up to 38-39 ° C, chills, indisposition. Neurological manifestations begin with temperate pains and paresthesias in the lower limbs, back and chest, carrying the root character. Then the maxima, sensitive and pelvic disorders appear for one to three days, the maximum, sensitive and pelvic disorders are reached: paralysis of both lower extremities (Paraplegia), true incontinence or delay in urine and feces, etc. With damage to the diaphragmal nerve, breathing disorders arise. In more rare cases, the inflammatory process covers only half of the spinal cord.

Treatment and forecast

With a given disease, an antibiotic semicircular spectrum of action is prescribed maximum doses, glucocorticosteroids, vitamins of group B and other drugs.

The disease very rarely passes without a trace, with coarse damage to the brain diameter after transferring meningoencephalomyelitis, a persistent paraplegy remains. More often, if the movement and restores, the element of spasticity in gait, paresthesia, cramps in the legs remains.