What is the role of EEG in the diagnosis 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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Answer

Electroencephalography (EEG), though lacking in specificity (32%), has 84% sensitivity to abnormal patterns in HSE. Focal abnormalities (eg, spike and slow- or periodic sharp-wave patterns over the involved temporal lobes) or diffuse slowing may be observed.

Periodic complexes and periodic lateralizing epileptiform discharges (PLEDs), in the proper clinical context, are strongly suggestive of HSE. However, Beneto et al reported 9 patients with confirmed HSE who had no PLED activity or had other EEG patterns. [34]


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