FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 304:313-318 February 5, 1981 Number 6 Next

	Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

Abstract

To learn more about the treatment of herpes simplex encephalitis with vidarabine, we conducted an uncontrolled study of 132 patients referred to 22 hospitals because of suspected disease. All had a brain biopsy and were started on vidarabine, but only 75 were diagnosed by isolation of virus from a brain-biopsy specimen. Cumulative mortality in the latter group was 39 per cent at one year. Other than therapy, levels of consciousness and age were the major variables that influenced outcome. Of 23 patients under 30 years of age who were lethargic at the initiation of therapy, two died and 16 returned to normal. Of 26 patients over 30 years of age who were lethargic at the outset, nine died and 10 returned to normal. Semicoma and coma were associated with worse outcomes, especially in older patients. Our data suggest that outcome is improved with treatment; they provide more support for the use of brain biopsy to diagnose the infection and indicate a need for better therapy.

This article has been cited by other articles:

• Whitley, R. J., Kimberlin, D. W. (1999). Viral Encephalitis. Pediatr. Rev. 20: 192-198 [Full Text]  
• Wang, H.-S., Huang, S.-C. (1993). Value of Serum Anti-Herpes Simplex Viral IgM Antibody Testing in Empirical Antiviral Treatment of Herpes Simplex Encephalitis. J Child Neurol 8: 378-382 [Abstract]  
• Sawyer, J., Ellner, J., Ransohoff, D. F. (1988). To Biopsy or Not to Biopsy in suspected Herpes Simplex Encephalitis: A Quantitatiue Analysis. Med Decis Making 8: 95-101 [Abstract]  
• Hanley, D. F., Johnson, R. T., Whitley, R. J. (1987). Yes, Brain Biopsy Should Be a Prerequisite for Herpes Simplex Encephalitis Treatment. Arch Neurol 44: 1289-1290 [Abstract]  
• Laskin, O. L., Stahl-Bayliss, C. M., Morgello, S. (1987). Concomitant Herpes Simplex Virus Type 1 and Cytomegalovirus Ventriculoencephalitis in Acquired Immunodeficiency Syndrome. Arch Neurol 44: 843-847 [Abstract]  
• Watson, D. F., Stern, B. J., Levin, M. L., Dutta, D. (1985). Isolated Cerebral Phycomycosis Presenting as Focal Encephalitis. Arch Neurol 42: 922-923 [Abstract]  
• Russell, J., Fisher, M., Zivin, J. A., Sullivan, J., Drachman, D. A. (1985). Status Epilepticus and Epstein-Barr Virus Encephalopathy: Diagnosis by Modern Serologic Techniques. Arch Neurol 42: 789-792 [Abstract]  
• Dolin, R (1985). Antiviral chemotherapy and chemoprophylaxis. Science 227: 1296-1303 [Abstract]  
• Saito, Y, Price, R., Rottenberg, D., Fox, J., Su, T., Watanabe, K., Philips, F. (1982). Quantitative autoradiographic mapping of herpes simplex virus encephalitis with a radiolabeled antiviral drug. Science 217: 1151-1153 [Abstract]