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Herpes Encephalitis
Miral D. Jhaveri, MD; Karen L. Salzman, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          TERMINOLOGY

          • Abbreviations

            • Herpes simplex encephalitis (HSE)
          • Definitions

            • Brain parenchyma infection caused by herpes simplex virus type 1 (HSV1)
            • Typically reactivation in immunocompetent patients

          IMAGING

          • General Features

            • CT Findings

              • MR Findings

                • Imaging Recommendations

                  DIFFERENTIAL DIAGNOSIS

                    PATHOLOGY

                    • General Features

                      • Staging, Grading, & Classification

                        • Gross Pathologic & Surgical Features

                          • Microscopic Features

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Consider

                                      • Image Interpretation Pearls

                                        Selected References

                                        1. Hatanpaa KJ et al: Neuropathology of viral infections. Handb Clin Neurol. 123:193-214, 2014
                                        2. Mahan M et al: Neuroimaging of viral infections of the central nervous system. Handb Clin Neurol. 123:149-73, 2014
                                        3. Steiner I et al: Update on herpes virus infections of the nervous system. Curr Neurol Neurosci Rep. 13(12):414, 2013
                                        4. Studahl M et al: Acute viral infections of the central nervous system in immunocompetent adults: diagnosis and management. Drugs. 73(2):131-58, 2013
                                        5. Ibitoye RT et al: Pitfalls in the management of herpes simplex virus encephalitis. BMJ Case Rep. 2012, 2012
                                        6. Sureka J et al: Clinico-radiological spectrum of bilateral temporal lobe hyperintensity: a retrospective review. Br J Radiol. 85(1017):e782-92, 2012
                                        7. Akyldz BN et al: Diffusion-weighted magnetic resonance is better than polymerase chain reaction for early diagnosis of herpes simplex encephalitis: a case report. Pediatr Emerg Care. 24(6):377-9, 2008
                                        8. Baringer JR: Herpes simplex infections of the nervous system. Neurol Clin. 26(3):657-74, viii, 2008
                                        9. Bulakbasi N et al: Central nervous system infections of herpesvirus family. Neuroimaging Clin N Am. 18(1):53-84; viii, 2008
                                        10. Hatipoglu HG et al: Magnetic resonance and diffusion-weighted imaging findings of herpes simplex encephalitis. Herpes. 15(1):13-7, 2008
                                        11. Kataoka H et al: Early dynamic SPECT imaging in acute viral encephalitis. J Neuroimaging. 17(4):304-10, 2007
                                        12. Obeid M et al: Diffusion-weighted imaging findings on MRI as the sole radiographic findings in a child with proven herpes simplex encephalitis. Pediatr Radiol. 37(11):1159-62, 2007
                                        13. Rimon A et al: West Nile encephalitis mimicking herpes encephalitis. Pediatr Neurol. 35(1):62-4, 2006
                                        14. Whitley RJ: Herpes simplex encephalitis: adolescents and adults. Antiviral Res. 71(2-3):141-8, 2006
                                        15. Duckworth JL et al: Magnetic resonance restricted diffusion resolution correlates with clinical improvement and response to treatment in herpes simplex encephalitis. Neurocrit Care. 3(3):251-3, 2005
                                        16. Kuker W et al: Diffusion-weighted MRI in herpes simplex encephalitis: a report of three cases. Neuroradiology. 46(2):122-5, 2004
                                        17. Kaga K et al: Auditory agnosia in children after herpes encephalitis. Acta Otolaryngol. 123(2):232-5, 2003
                                        18. Sämann PG et al: Serial proton MR spectroscopy and diffusion imaging findings in HIV-related herpes simplex encephalitis. AJNR Am J Neuroradiol. 24(10):2015-9, 2003
                                        19. Cakirer S et al: MR imaging in epilepsy that is refractory to medical therapy. Eur Radiol. 12(3):549-58, 2002
                                        20. Bash S et al: Mesiotemporal T2-weighted hyperintensity: neurosyphilis mimicking herpes encephalitis. AJNR Am J Neuroradiol. 22(2):314-6, 2001
                                        21. Kleinschmidt-DeMasters BK et al: The expanding spectrum of herpesvirus infections of the nervous system. Brain Pathol. 11(4):440-51, 2001
                                        22. Teixeira J et al: Diffusion imaging in pediatric central nervous system infections. Neuroradiology. 43(12):1031-9, 2001
                                        23. Leonard JR et al: MR imaging of herpes simplex type 1 encephalitis in infants and young children: a separate pattern of findings. AJR Am J Roentgenol. 174(6):1651-5, 2000
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Terminology

                                          • Imaging

                                            • Top Differential Diagnoses

                                              • Clinical Issues

                                                TERMINOLOGY

                                                • Abbreviations

                                                  • Herpes simplex encephalitis (HSE)
                                                • Definitions

                                                  • Brain parenchyma infection caused by herpes simplex virus type 1 (HSV1)
                                                  • Typically reactivation in immunocompetent patients

                                                IMAGING

                                                • General Features

                                                  • CT Findings

                                                    • MR Findings

                                                      • Imaging Recommendations

                                                        DIFFERENTIAL DIAGNOSIS

                                                          PATHOLOGY

                                                          • General Features

                                                            • Staging, Grading, & Classification

                                                              • Gross Pathologic & Surgical Features

                                                                • Microscopic Features

                                                                  CLINICAL ISSUES

                                                                  • Presentation

                                                                    • Demographics

                                                                      • Natural History & Prognosis

                                                                        • Treatment

                                                                          DIAGNOSTIC CHECKLIST

                                                                          • Consider

                                                                            • Image Interpretation Pearls

                                                                              Selected References

                                                                              1. Hatanpaa KJ et al: Neuropathology of viral infections. Handb Clin Neurol. 123:193-214, 2014
                                                                              2. Mahan M et al: Neuroimaging of viral infections of the central nervous system. Handb Clin Neurol. 123:149-73, 2014
                                                                              3. Steiner I et al: Update on herpes virus infections of the nervous system. Curr Neurol Neurosci Rep. 13(12):414, 2013
                                                                              4. Studahl M et al: Acute viral infections of the central nervous system in immunocompetent adults: diagnosis and management. Drugs. 73(2):131-58, 2013
                                                                              5. Ibitoye RT et al: Pitfalls in the management of herpes simplex virus encephalitis. BMJ Case Rep. 2012, 2012
                                                                              6. Sureka J et al: Clinico-radiological spectrum of bilateral temporal lobe hyperintensity: a retrospective review. Br J Radiol. 85(1017):e782-92, 2012
                                                                              7. Akyldz BN et al: Diffusion-weighted magnetic resonance is better than polymerase chain reaction for early diagnosis of herpes simplex encephalitis: a case report. Pediatr Emerg Care. 24(6):377-9, 2008
                                                                              8. Baringer JR: Herpes simplex infections of the nervous system. Neurol Clin. 26(3):657-74, viii, 2008
                                                                              9. Bulakbasi N et al: Central nervous system infections of herpesvirus family. Neuroimaging Clin N Am. 18(1):53-84; viii, 2008
                                                                              10. Hatipoglu HG et al: Magnetic resonance and diffusion-weighted imaging findings of herpes simplex encephalitis. Herpes. 15(1):13-7, 2008
                                                                              11. Kataoka H et al: Early dynamic SPECT imaging in acute viral encephalitis. J Neuroimaging. 17(4):304-10, 2007
                                                                              12. Obeid M et al: Diffusion-weighted imaging findings on MRI as the sole radiographic findings in a child with proven herpes simplex encephalitis. Pediatr Radiol. 37(11):1159-62, 2007
                                                                              13. Rimon A et al: West Nile encephalitis mimicking herpes encephalitis. Pediatr Neurol. 35(1):62-4, 2006
                                                                              14. Whitley RJ: Herpes simplex encephalitis: adolescents and adults. Antiviral Res. 71(2-3):141-8, 2006
                                                                              15. Duckworth JL et al: Magnetic resonance restricted diffusion resolution correlates with clinical improvement and response to treatment in herpes simplex encephalitis. Neurocrit Care. 3(3):251-3, 2005
                                                                              16. Kuker W et al: Diffusion-weighted MRI in herpes simplex encephalitis: a report of three cases. Neuroradiology. 46(2):122-5, 2004
                                                                              17. Kaga K et al: Auditory agnosia in children after herpes encephalitis. Acta Otolaryngol. 123(2):232-5, 2003
                                                                              18. Sämann PG et al: Serial proton MR spectroscopy and diffusion imaging findings in HIV-related herpes simplex encephalitis. AJNR Am J Neuroradiol. 24(10):2015-9, 2003
                                                                              19. Cakirer S et al: MR imaging in epilepsy that is refractory to medical therapy. Eur Radiol. 12(3):549-58, 2002
                                                                              20. Bash S et al: Mesiotemporal T2-weighted hyperintensity: neurosyphilis mimicking herpes encephalitis. AJNR Am J Neuroradiol. 22(2):314-6, 2001
                                                                              21. Kleinschmidt-DeMasters BK et al: The expanding spectrum of herpesvirus infections of the nervous system. Brain Pathol. 11(4):440-51, 2001
                                                                              22. Teixeira J et al: Diffusion imaging in pediatric central nervous system infections. Neuroradiology. 43(12):1031-9, 2001
                                                                              23. Leonard JR et al: MR imaging of herpes simplex type 1 encephalitis in infants and young children: a separate pattern of findings. AJR Am J Roentgenol. 174(6):1651-5, 2000