What are the signs and symptoms of herpes simplex encephalitis (HSE)?

Updated: Jul 17, 2018
  • Author: Wayne E Anderson, DO, FAHS, FAAN; Chief Editor: Niranjan N Singh, MBBS, MD, DM, FAHS, FAANEM  more...
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Patients with HSE may have a prodrome of malaise, fever, headache, and nausea, followed by acute or subacute onset of an encephalopathy whose symptoms include lethargy, confusion, and delirium. However, no pathognomonic clinical findings reliably distinguish HSE from other neurologic disorders with similar presentations. [4]

The following are typically the most common symptoms of HSE [5] :

  • Fever (90%)

  • Headache (81%)

  • Psychiatric symptoms (71%)

  • Seizures (67%)

  • Vomiting (46%)

  • Focal weakness (33%)

  • Memory loss (24%)

The initial presentation may be mild or atypical in immunocompromised patients (eg, those with HIV infection or those receiving steroid therapy). [6]

See Clinical Presentation for more detail.

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