Long term cognitive outcome in herpes simplex encephalitis
Journal Title: Indian Journal of Neurosciences - Year 2018, Vol 4, Issue 1
Abstract
Aims Herpes Simplex Encephalitis HSE is a leading cause of acquired cognitive disability We aimed to describe cognitive sequelae of HSE in relation to clinical variables during hospitalizationMethods Consecutive cases of encephalitis with a discharge diagnosis of HSE from January 2010 to December2016 were reviewed to collect the clinical details GlasgowOutcomeScore GOS BarthelIndex BI SeizureScore EngelScore ES at the time of discharge first followup and final followup were noted A detailed neuropsychological evaluation was done at last followup in survivors and these scores were compared to clinical variables during hospitalization c2 test Fisherrsquos exact test and ANOVA were used for analysisResults There were 30 patients 11males at a median age of 315years Cerebrospinalfluid was abnormal in 828 electroencephalogram in 967 and Magnetic Resonance Imaging MRI in 80 patients All were treated with acyclovir and 80 had intensivecareunit stay Mortality was 267 and it correlated with glasgow coma score lt8 status epilepticus and Periodic Lateralized Epileptiform Discharges PLEDs in electroencephalogram At the first followup of 84plusmn52 weeks and final followup of 366plusmn265 months survivors had a good functional recovery with GOS45 and BI90100 At final followup median ES was one ES was not correlated with seizures statusepilepticus electroencephalogram or MRI features At final followup 518278 had significant neuropsychological verified cognitive abnormalities and those with longest followup had least abnormalities Neuropsychological profile didnrsquot correlate with any clinical variables other than the association of poor attention score and orbitofrontal signal changes in MRIConclusions Acyclovir treated HSE has a mortality of 267 but survivors have good functionalseizure outcome Significant cognitive problems occur in a third but not related to any clinical variablesKeywords Encephalitis Herpes Outcome Cognitive outcome Neuropsychology
Authors and Affiliations
Firosh Khan, Fazal Ghafoor, Abdulkhader Shehna
Keywords
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