The meninges are the layers of thin tissue that cover your brain. If these tissues become infected, it’s called meningitis. When your brain becomes inflamed or infected, the problem is called encephalitis. If both the meninges and the brain are infected, the condition is called meningoencephalitis.
Encephalitis involving herpes is a medical emergency. It needs to be promptly diagnosed and treated. This disease is often fatal when it is not treated. Many people who survive it have long-term problems afterward.
Meningitis and encephalitis may be caused by bacteria, fungi, or other types of germs. But many are caused by viruses, and many kinds of viruses can be to blame.
Encephalitis is caused by the herpes simplex virus. Most are caused by herpes simplex virus type 1 (HSV1), the virus that also causes cold sores. The disease may also be caused by herpes virus type 2 (HSV2). This virus can be spread by sexual contact or from an infected mother to her baby during childbirth. HSV1 infection can also be sexually transmitted to the genital area. These viruses remain in the body throughout a person's life, even when they're not causing signs of infection.
Sometimes the meningoencephalitis occurs during the initial infection with the herpes simplex virus, but most often it is caused by reactivation of the virus from an earlier infection.
If you have viral meningitis, symptoms may include fever, light sensitivity, headache, and a stiff neck. If you have other symptoms, such as confusion, seizures, sleepiness, or a focal neurologic deficit—a nerve function problem that affects a specific area — these may suggest that your brain is also affected, and your healthcare provider may diagnose it as meningoencephalitis.
These are possible symptoms of meningoencephalitis:
If, after reviewing your medical history and symptoms, your healthcare provider thinks you may have herpes meningoencephalitis, he or she will order various tests and exams to confirm the diagnosis. Other tests may include:
If your healthcare providers think that a newborn has herpes encephalitis resulting from infection with HSV2 while passing through the birth canal, they may check samples of the baby's blood and spinal fluid.
Treating the cause of your infection is the primary treatment. Since most cases of meningoencephalitis are caused by the herpes virus, the antiviral acyclovir is used to treat it. You may need to take this medicine through an intravenous (IV) line for 10 to 14 days. Your healthcare provider may also give you medicine to reduce swelling in the brain and to treat or prevent seizures.
Healthcare providers may treat babies with this disease with acyclovir for several weeks.
Depending on the severity of your infection, you may need to be treated in the hospital.
With treatment, most people with this disease start to improve within a day or two and tend to recover fully within about a month. But without treatment, very serious complications can set in, including death.
Even with treatment, some people with severe cases may have long-term brain damage. They may have trouble thinking, controlling their body, and hearing, seeing, or speaking. They may need to take medicines for a long time, and they may require long-term care.
Avoiding herpes virus infections in the first place can help you prevent herpes meningoencephalitis. Ways to avoid infections from herpes viruses include:
Some pregnant women who have had genital herpes outbreaks may want to have their babies delivered by cesarean section. This may prevent meningoencephalitis in newborns.
Treating herpes meningoencephalitis as soon as possible is essential. If you’re feeling neck stiffness, having any neurological problems (including seizures, changes in consciousness, or feeling sleepy), are sensitive to light, or are running a fever along with a bad headache, call your healthcare provider and have the problem treated promptly.
If you have already been diagnosed with herpes meningoencephalitis and are being treated, it's very important to let your healthcare providers know if any of your symptoms get worse or if you develop any new symptoms, as these could be signs that the infection is getting worse despite treatment.
Tips to help you get the most from a visit to your healthcare provider:
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