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A diagnosis of herpes simplex encephalitis was confirmed in 42 patients. Five patients(12%)died in the first month.Three patients(7%)had severe neurological sequelae and died after a longer interval.All but one of the 34 surviving patients had neurological symptoms,an abnormal neurological examination,or both.Twenty patients(48%)performed everyday activities as well as before herpes simplex encephalitis;nine patients(21%)were living independently,but were functioning at a lower level than before the illness;and five patients(12%)had a severe neurological deficit.Twenty nine of the 34 survivors were assessed six months to 11 years after herpes simplex encephalitis.The most common long term symptoms were memory impairment(69%),personality and behavioural abnormalities(45%),and epilepsy(24%).Short term memory impairment(70%),anosmia(65%),and dysphasia (415)were the most common signs.Although acyclovir has reduced the mortality of herpes simplex encephalitis,30%of this group of patients either died or had a severe neurological deficit.The other 70%of the patients regained independence in activities of daily living,but most of these people had persistent neurological symptoms,signs,or both. |
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