Herpes is a chronic viral infection that affects the skin, mucous membranes, nervous system and, in severe cases, internal organs. In weakened people and if the disease is not treated correctly, the brain may be damaged. Encephalitis (inflammation of the brain substance), encephalomyelitis (combined damage to the brain and spinal cord) or serous meningitis (inflammation of the membranes) develop. In the absence of proper assistance, the risk of death is high.
In weakened people and with improper treatment of herpes, the brain can be damaged.
Symptoms
With herpetic brain damage, the following symptoms are observed:
- Increase in body temperature to 39-40ºC and above. Indicates an inflammatory process and viremia (penetration of the herpes simplex virus into the blood). Fever may be the first symptom of the disease. It often occurs in waves.
- Strong headache. Intensifies with head movements, sudden noise and bright light. Constant and most often localized in the forehead and eye sockets.
- Pain in muscles and joints.
- Brokenness.
- Weakness.
- Nausea.
- Vomit. Can be multiple times. Has no connection with food intake.
- Increased skin sensitivity.
- Increased reaction to external stimuli (light, touch).
- Catarrhal phenomena in the form of runny nose and cough. Not observed in every patient.
- Visual disturbances in the form of strabismus, double vision and drooping of the upper eyelid. Indicate damage to the cranial nerves.
- “Spotting dog” pose (lying on your side with your head thrown back and legs pressed together).
- Rigidity (excessive tension) of the muscles in the back of the head.
- Dysphagia (difficulty swallowing).
- Impaired consciousness in the form of drowsiness and stupor. Coma and stupor are possible due to inflammation of the brain.
- Speech impairment (aphasia). Indicates a severe course of herpetic encephalitis. It is difficult for such people to speak.
- Ataxia (impaired coordination of movements and motor skills).
- Psychomotor agitation (indicates the development of viral encephalitis).
- Movement disorders in the form of paralysis and paresis.
In case of dysfunction of the cerebellum, patients experience sweeping movements, unsteadiness of gait, decreased muscle tone and tremor. In newborn babies, signs of herpes include cramps, bowed legs, bulging fontanelles and tearfulness. In young children with severe herpes, mental retardation may occur.
What factors contribute to the occurrence of herpes zoster?
Herpes zoster can only appear in people who have previously been infected with the varicella zoster virus, often through natural infection, and who have had chickenpox or, less commonly, as a result of the chickenpox vaccine.
A factor in the development of herpes zoster is age. The risk of herpes zoster increases rapidly after age 50. After 85 years of age, the risk of herpes zoster is 50%. Likewise, with age, the risk of developing postherpetic neuralgia increases sharply. In this regard, elderly patients with herpes zoster may require hospitalization to treat complications of the disease, including neuralgia.
Risk factors for the development of herpes zoster include diseases that lead to a decrease in cellular immunity, such as disseminated tumors, including leukemia and lymphoma, infection with the human immunodeficiency virus (HIV), as well as immunosuppressive therapy (glucocorticosteroids, drugs prescribed after organ transplantation).
Patients who receive immunosuppressive therapy, including glucocorticosteroids, are especially prone to severe herpes zoster. A risk factor is treatment of cancer with radiotherapy or chemotherapy.
Reasons for appearance
Herpes cerebri is caused by HSV (herpes simplex virus). Infection occurs by airborne droplets, household contact or transplacental (through the placenta from a sick mother) routes.
Once in the human body, the virus leads to damage to the nerve trunks of the brain.
This dangerous pathology is the result of initial contact with the virus or the process of reactivation of the pathogen due to decreased immunity or stress. The disease can develop against the background of herpes simplex of the lips if treatment recommendations are not followed.
A brain disease can develop against the background of herpes simplex labialis if treatment recommendations are not followed.
The process of disease development
In a young body, the primary herpes virus is capable of taking the form of encephalitis herpes. In this situation, pathogens enter the human central nervous system from the mucous membrane of the nasal cavity, moving along unequal fibers that are responsible for the sense of smell. But many adults suffering from encephalitic herpes already have episodes of the disease in the past, or they are active carriers of the HSV-1 virus.
Every 4 patients with brain herpes show the presence of different varieties of the virus during laboratory analysis of materials from the mucous membrane of the oropharynx. In such cases, brain inflammation can be explained by repeated infection with HSV-1 with its subsequent introduction into the central nervous system.
In order to describe in detail the reasons for the development of the inflammatory process of the brain, namely those cases when strains of the same species were found on the mucous membrane of the oropharynx and in the tissues of the brain, 2 hypotheses were made:
- The first says - a recurrent manifestation of the herpetic encephalitis virus in the trigeminal or autonomic ganglia, with spread to the parts of the central nervous system along the nerve fibers.
- The second hypothesis is that herpes remains in a latent state for a very long time immediately in the central nervous system, where it is reactivated.
Diagnosis and treatment
If you suspect a cerebral (brain) form of herpetic infection, you will need:
- interviewing the patient or his relatives;
- physical examination;
- external examination of the skin and mucous membranes;
- determination of meningeal symptoms (stiffness of the neck muscles, Kernig, Brudzinski);
- CT or MRI of the brain;
- analysis of cerebrospinal fluid (with encephalitis the number of lymphocytes increases);
- general clinical blood and urine tests;
- blood test for antibodies to the herpes virus;
- neurological examination;
- polymerase chain reaction;
- electroencephalography.
If you suspect a cerebral form of herpetic infection, you will need to interview the patient.
For brain damage caused by herpes, the following drugs are used:
- systemic antiherpetic agents in the form of a solution for intravenous infusion (Acyclovir, Zovirax);
- systemic corticosteroids (Dexamethasone-Ferein);
- immunostimulants (interferons, Polyoxidonium);
- immunoglobulin (administered to people with weak immune systems);
- antipyretics (Ibuprofen, Paracetamol MS, Panadol);
- diuretics (Lasix, Furosemide);
- neuroprotectors (Glycine, Piracetam);
- vitamins (Kombilipen, Milgamma);
- anticonvulsants (used for seizures).
If necessary, infusion therapy is performed.
Viruses 6–7 types
Today, viruses 6–7 types of herpes are still poorly studied. However, the range of diseases that develop against the background of infection with them is quite large. For example, the list includes chronic fatigue syndrome, sudden exanthema (allergic skin rashes) on the skin in children, necrotizing lymphadenitis and infectious mononucleosis not associated with the Epstein-Barr virus. In addition, such herpes can lead to conditions of immunodeficiency, the development of malignant tumors and lymphomas.
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Often, herpes virus type 6-7 becomes the cause of a long-term “cold”. A person has all the classic symptoms of a viral pathology - runny nose, cough, high fever. However, the course of the disease is essentially different - a fever with fairly high numbers on the thermometer will last longer than the prescribed 3 days. At the same time, no improvements in the person’s condition are observed - the fever is difficult to reduce with special medications and returns quite quickly. Sometimes it may be the only symptom of the disease. Despite the fact that it is believed that on the 4th day that symptoms persist, a viral disease becomes bacterial, in the case of the herpes virus, blood test results will remain “viral” even on the 5th–6th day of illness.
Complications of the disease caused by the herpes virus type 6–7 include neurological complications, seizures, and hepatitis. The particular danger of such a virus is that it activates the oncoproteins of the human papillomavirus, and is also an oncogenic problem and causes the development of carcinomas.
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The 7th type of herpes virus can also cause mental and psychological problems: sleep disturbance, memory impairment, increased irritability, decreased intelligence, depression and difficulty concentrating. Also, against the background of activation of herpes, rapid changes in body weight, problems with the gastrointestinal tract, loss of appetite, arrhythmia, fatigue, and allergies may occur.
Complications and rehabilitation
If herpes in the brain is not treated correctly, the following consequences are possible:
- speech disorders;
- nerve damage;
- hydrocephalus (accumulation of cerebrospinal fluid in the brain);
- persistent limitation of movements in the limbs;
- visual impairment.
If herpes in the brain is not treated correctly, visual impairment may occur.
With proper treatment, the prognosis is relatively favorable.
In its absence, the risk of death is 70-75%.
Even when the symptoms of herpes are eliminated, long-term rehabilitation is often required.
Herpetic encephalitis
The most dangerous damage to the brain is caused by the virus. This is fraught with swelling, displacement of structures and their compression. Herpetic encephalitis can lead to epileptic seizures, respiratory and cardiovascular failure, increased intracranial pressure, mental disorders, hearing loss and coma.
Prevention of herpetic encephalitis and meningitis includes increasing immunity, using a vaccine (for people at risk), taking vitamins, avoiding stress, eating well and following doctor's orders.
The contagiousness of herpes zoster to others
The VZV virus, which causes herpes zoster, can be spread from people with active herpes zoster to people susceptible to VZV infection, that is, those who have not yet had chickenpox. In such cases, chickenpox may develop, while herpes zoster will not directly develop. Herpes zoster is much less contagious than chickenpox, and the risk of contracting VZV after exposure is low. The VZV virus spreads through direct contact with fluid found in the herpes rash (vesicles), while brief, casual contact is safe. Patients with herpes zoster are contagious to others in the phase of a non-dried vesicular rash, but are not contagious before the rash appears and after the vesicles dry out with the formation of crusts. It is recommended that a person with herpes zoster cover the rash with clothing, which significantly reduces the infectiousness to others. People at greatest risk of severe chickenpox include pregnant women, premature babies born to mothers susceptible to chickenpox, babies born before 28 weeks' gestation or weighing less than 1000 grams, regardless of whether the mother has had chickenpox smallpox or has been vaccinated, as well as patients with impaired immunity, regardless of age.
