LONG-TERM COGNITIVE SEQUELAE OF ACYCLOVIR-TREATED HERPES-SIMPLEX ENCEPHALITIS
LONG-TERM COGNITIVE SEQUELAE OF ACYCLOVIR-TREATED HERPES-SIMPLEX ENCEPHALITIS
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DOI：
10.1001/archneur.1990.00530060054017
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发表时间：
1990-06-01
影响因子：
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通讯作者：
WHITLEY, RJ
中科院分区：
文献类型：
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作者：
GORDON, B;SELNES, OA;WHITLEY, RJ
众所周知，未经治疗的单纯疱疹病毒1型脑炎的存活率伴随着严重的认知障碍。最近，阿昔洛韦已被证明是治疗这种疾病的最有效的可用疗法，但它可以显著降低发病率。我们对连续四名患者进行了详细的评估，这些患者在活检证实的疱疹病毒性脑炎的早期阶段接受了阿昔洛韦治疗，现在已经被随访了1.5到4年。所有四名患者在临床或全息神经心理测试中都显示出明确的残留，最常见的是失眠和语言和视觉材料的新学习障碍，尽管其中三名患者在标准的临床精神状态测试中表现正常。所有四名患者都无法达到之前的功能水平。因此，尽管早期使用阿昔洛韦治疗疱疹脑炎，但可能会有长期的神经心理残留。此外，临床筛查可能无法发现对预后有重要意义的认知缺陷。
Survival from untreated herpes simplex type 1 encephalitis is well known to be accompanied by severe cognitive impairments. Recently, acyclovir has been proven to be the most effective available treatment for this disease, with the exceptation that it would appreciably reduce morbidity. We performed detailed assessments of four consecutive patients who received acyclovir in the early stages of biopsy-proven herpes encephalitis and who now have been followed up for 1.5 to 4 years. All four patients showed definite residual on either clinical or foraml neuropsychological testing, most commonly dysnomia and impaired new learning for both verbal and visual material, even though three had normal performance on a standard clinical mental status test. All four patients were unable to function at their prior level of achievement. Therefore, despite early administration of acyclovir in herpes encephalitis, long-lasting neuropsychological residual are likely. Furthermore, cognitive deficits of prognostic importance may not be detected by clinical screening.