Which physical findings suggest 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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Answer

The most frequent findings on physical examination are fever and mental status abnormalities. Meningeal signs may be present, but meningismus is uncommon.

Typical findings on presentation include the following [5] :

  • Alteration of consciousness (97%)

  • Fever (92%)

  • Dysphasia (76%)

  • Ataxia (40%)

  • Seizures (38%) - Focal (28%); generalized (10%)

  • Hemiparesis (38%)

  • Cranial nerve defects (32%)

  • Visual field loss (14%)

  • Papilledema (14%)


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