Herpetic meningoencephalitis in the elderly. Apropos of 13 cases

La Revue de médecine interne
P JouannyP Canton

Abstract

In a retrospective analysis of 13 cases of Herpes simplex encephalitis (mean age: 67.2 +/- 6.4 years; ten women, three men), the authors conclude that this infection is more often due to Herpes simplex virus 1 in the elderly. Diagnosis is difficult at an early stage, and must be suspected in case of confusion (9/13), especially feverish (11/13), associated with neurological signs (10/13), and particularly epilepsy (5/13). It requires a lumbar puncture which collect a clear and lymphocytic fluid. Prognosis of this encephalitis depends on early diagnosis and an presumptive therapy with acyclovir. EEG is helpful showing periodic activity (10/13). CT scan and MRI can show unspecific abnormalities, but often too late. Laboratory findings will secondarily confirm the diagnosis quite frequently, using new Elisa methods. Polymerase chain reaction allows earlier diagnosis. Geriatric cases seem more often due to reinfection or to endogen virus reactivation rather than to primary infection.

Citations

Aug 7, 2007·Neuropsychological Rehabilitation·Laura Hokkanen, Jyrki Launes
Feb 4, 2010·Journal of the American Geriatrics Society·Antoni Riera-MestrePedro Fernández-Viladrich
Mar 14, 2008·Acta Neurologica Scandinavica·A Hufschmidt, V Shabarin
Mar 27, 2002·Clinics in Geriatric Medicine·Mervyn L Elgart
Sep 6, 2008·Journal de radiologie·F Brami-ZylberbergJ F Meder

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