Herpes Encephalitis

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KEY POINTS

• Herpes encephalitis is an infection that causes swelling and irritation (inflammation) of the brain.
• Herpes encephalitis is treated in the hospital. You may get IV fluids and medicines to treat infections and prevent seizures.
• The best way to prevent herpes encephalitis is to prevent infections. Ask your healthcare provider how to take care of yourself at home.

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What is herpes encephalitis?

Herpes encephalitis is an infection of the brain and central nervous system caused by the herpes simplex virus.

Herpes encephalitis can be mild, or it may damage the brain and cause trouble walking, talking, and remembering. It can be life-threatening.

What is the cause?

Herpes encephalitis is caused by the same virus that causes cold sores (fever blisters) and genital herpes. The herpes simplex virus causes painful blisters on the skin that can last for several days. You may have sores around your mouth or in your genital or buttocks area. Once you are infected, the virus continues to live in your body, even after the first sores are gone.

In rare cases, the virus spreads to the nerves and brain and causes herpes encephalitis. This usually happens only when you have a medical condition that weakens your immune system such as diabetes or HIV. The immune system is your body’s defense against infection.

The virus can be passed from a pregnant woman to her baby during birth. It can cause serious problems for the baby, sometimes even death. If a newborn is infected and survives the infection, the baby may have damage to the brain or other parts of the nervous system.

What are the symptoms?

At first, you may feel like you have the flu. You may have a headache, fever, and muscle aches. Over several hours or days, the symptoms may get worse. More severe symptoms may include:

• Unusual drowsiness
• Confusion or memory problems
• Trouble walking
• Changes in behavior or irritability
• Sensitivity to light
• Pain or stiffness in the neck
• Unusual lack of appetite
• Vomiting
• Seizures
• Coma

If you or someone else has these symptoms, call 911 for emergency help right away.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. Tests may include:

• Blood tests
• CT scan, which uses X-rays and a computer to show detailed pictures of the brain
• MRI, which uses a strong magnetic field and radio waves to show detailed pictures of the brain
• EEG (electroencephalogram), which uses small wires pasted or taped to your head to measure and record the electrical activity of your brain
• Lumbar puncture, also called a spinal tap, which uses a needle to get a sample of fluid from the area around your spinal cord

How is it treated?

Encephalitis is treated in the hospital. You may be in the intensive care unit. If you need help breathing, you may need a breathing machine. These life-support treatments are used until you start to get better. You may get IV fluids and medicines to:

• Treat the herpes virus infection
• Prevent or treat seizures
• Prevent or treat brain swelling
• Prevent or treat nausea and vomiting

You may start a rehabilitation (rehab) program to help you recover from problems caused by the infection. This may include physical therapy, occupational therapy, or speech therapy.

• Physical therapy can help your muscles get strong again. You will learn ways to move safely if you have weak or paralyzed muscles.
• Occupational therapy may help if you have problems doing things like eating and getting dressed.
• Speech therapy may help if you have problems with swallowing, speaking, or understanding words.

How can I take care of myself?

Follow the treatment plan your provider recommends.

Ask your provider:

• How and when you will get your test results
• How to take care of yourself at home
• How long it will take to recover from this illness
• If there are activities you should avoid and when you can return to normal activities
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

How can I help prevent herpes encephalitis?

The herpes virus is easily spread between people by direct contact with a herpes sore or by contact with the saliva of someone with the infection such as when kissing or with direct contact sports competitions like wrestling.

Genital herpes is a sexually transmitted disease (STD). Babies can be infected during the birth process.

When you have herpes blisters anywhere on your body:

• Avoid touching the blisters. The blister fluid contains live virus. If you do touch a blister, wash your hands as soon as possible. Wash your hands well but gently. This helps prevent damage to your skin and openings for the virus to get into another part of the body. Don’t touch the sores and then touch your eyes or nose, where the infection could be spread.
• Tell any sexual partner that you have herpes before having sex. Use latex or polyurethane condoms during foreplay and every time you have oral, vaginal, or anal sex.
• Avoid kissing, foreplay, or sex when you have a cold sore or sores on your genitals.
• Avoid sharing soaps, washcloths, cosmetics, and eating and drinking utensils. Wash dishes and utensils with detergent before others use them. Dispose of or wash your personal items, such as tissues and eating utensils, yourself.
• If you are pregnant or are planning to get pregnant, talk to your healthcare provider about ways to prevent giving herpes to your baby.