title: Prognostic Value of Initial Standard EEG and MRI in Patients with Herpes Simplex Encephalitis.
abstract: OBJECTIVE
  Herpes simplex encephalitis (HSE) is the most common type of sporadic encephalitis worldwide, and it remains fatal even when optimal antiviral therapy is applied. There is only a weak consensus on the clinical outcomes and prognostic factors in patients with HSE. This study examined whether the radiological and electrophysiological findings have a prognostic value in patients with HSE.
  
  
  METHODS
  We retrospectively analyzed patients who were diagnosed with HSE by applying the polymerase chain reaction to cerebrospinal fluid and who received intravenous acyclovir at our hospital from 2000 to 2014. We evaluated the clinical outcomes at 6 months after onset and their correlations with initial and clinical findings, including the volume of lesions on MRI, the severity of EEG findings, and the presence of epileptic seizures at the initial presentation.
  
  
  RESULTS
  Twenty-nine patients were enrolled (18 men and 11 women). Univariate analysis revealed that the presence of severe EEG abnormality and epileptic seizures at the initial presentation were significant correlated with a poor clinical outcome at 6 months (p=0.005 and p=0.009, respectively). In multivariate analysis, the presence of severe EEG abnormality was the only independent predictor of a poor outcome at 6 months (p=0.006).
  
  
  CONCLUSIONS
  In cases of HSE, the initial EEG severity and seizure presentation may be useful predictive factors for the outcome at 6 months after acyclovir treatment.
authors.affiliation: Department of Neurology, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea.|Department of Neurology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.
authors.forename: Young Soo
authors.initials: YS
authors.lastname: Kim
authors.affiliation: Department of Neurology, Seoul National University Hospital, Seoul, Korea.
authors.forename: Keun Hwa
authors.initials: KH
authors.lastname: Jung
authors.affiliation: Department of Neurology, Seoul National University Hospital, Seoul, Korea.
authors.forename: Soon Tae
authors.initials: ST
authors.lastname: Lee
authors.affiliation: Department of Neurology, Korea University Anam Hospital, Korea University School of Medicine, Seoul, Korea.
authors.forename: Bong Su
authors.initials: BS
authors.lastname: Kang
authors.affiliation: Department of Pediatrics, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea.
authors.forename: Jung Sook
authors.initials: JS
authors.lastname: Yeom
authors.affiliation: Department of Neurology, Seoul National University Hospital, Seoul, Korea.
authors.forename: Jangsup
authors.initials: J
authors.lastname: Moon
authors.affiliation: Department of Neurology, Seoul National University Hospital, Seoul, Korea.
authors.forename: Jung Won
authors.initials: JW
authors.lastname: Shin
authors.affiliation: Department of Neurology, Seoul National University Hospital, Seoul, Korea.
authors.forename: Sang Kun
authors.initials: SK
authors.lastname: Lee
authors.affiliation: Department of Neurology, Seoul National University Hospital, Seoul, Korea. stemcell.snu@gmail.com.
authors.forename: Kon
authors.initials: K
authors.lastname: Chu
keywords: electroencephalography; encephalitis; herpes simplex virus; polymerase chain reaction
references.citation: J Neurosci Methods. 2007 Sep 15;165(1):111-21
references.pmid: 17604116
references.citation: Neurol India. 2001 Dec;49(4):360-5
references.pmid: 11799408
references.citation: Comput Med Imaging Graph. 2001 Sep-Oct;25(5):391-7
references.pmid: 11390193
references.citation: J Neurol Neurosurg Psychiatry. 1994 Nov;57(11):1334-42
references.pmid: 7964808
references.citation: J Neurol Neurosurg Psychiatry. 1997 Sep;63(3):321-6
references.pmid: 9328248
references.citation: N Engl J Med. 1990 Jul 26;323(4):242-50
references.pmid: 2195341
references.citation: Neurology. 2003 Oct 14;61(7):1015-6
references.pmid: 14557588
references.citation: Pediatrics. 2007 Feb;119(2):e399-407
references.pmid: 17272602
references.citation: J Child Neurol. 2006 Dec;21(12):1047-51
references.pmid: 17156696
references.citation: Epilepsia. 2008 Aug;49 Suppl 6:13-8
references.pmid: 18754956
references.citation: Arch Neurol. 1990 Jun;47(6):646-7
references.pmid: 2346392
references.citation: Neuroradiology. 2004 Feb;46(2):122-5
references.pmid: 14747879
references.citation: Arch Neurol. 1975 Jan;32(1):39-43
references.pmid: 1115658
references.citation: Neuroradiology. 1992;34(6):490-3
references.pmid: 1436457
references.citation: J Clin Neurophysiol. 1988 Apr;5(2):161-74
references.pmid: 3074973
references.citation: Epilepsia. 2010 Jun;51(6):1069-77
references.pmid: 19889013
references.citation: N Engl J Med. 1986 Jan 16;314(3):144-9
references.pmid: 3001520
references.citation: Lancet. 1975 Mar 1;1(7905):480-4
references.pmid: 46957
references.citation: Clin Infect Dis. 2002 Aug 1;35(3):254-60
references.pmid: 12115090
references.citation: Acta Neurol Scand. 1982 Oct;66(4):462-71
references.pmid: 7148389
references.citation: Arch Neurol. 1982 Feb;39(2):99-102
references.pmid: 7059308
references.citation: Lancet. 1970 Mar 28;1(7648):650-2
references.pmid: 4190634