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Medicine General 7b2137b2

Which of the following is FALSE regarding the clinical features of Herpes Simplex Encephalitis?

A
Alterations in behaviour
B
Olfactory hallucinations
C
Hemiparesis
D
None of the above
High-Yield Explanation
There is usually a prodrome of malaise, fever (90%), headache (81%), and nausea and vomiting (46%) lasting for a few days, consistent with a viral infection. On this background, features raising suspicion of encephalitis include the concurrent onset of: Progressive alterations of behaviour (71%) Features suggestive of focal epilepsy (67%), such as olfactory hallucinations or periods of altered awareness Focal neurological signs (33%), such as unilateral weakness Cognitive problems (24%), such as difficulty in word finding, memory impairment, or confusion Note: Of the two types of herpes simplex virus (HSV-1 and HSV-2), HSV-1 encephalitis is more common in adults, and HSV-2 infection is more common in neonates. Ref: Herpes simplex encephalitis, Mazen Sabah, James Mulcahy,, Adam Zeman ; BMJ 2012;344:e3166

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