The Comparison Of Acyclovir Efficacy Between Supported Cerebral MRI And Unsupported To Herpes Simplex Virus Encephalitis

Objective The mortality and disability rate of Herpes simplex virus encephalitis (HSVE) significantly reduce with the use of acyclovir .But the therapeutic effect is different in patients. There are several cases suspected to HSVE with clinical symptom. Some in line with HSVE in cerebral MRI,but others do not ,even having normal manifestation . We would like to observe the different effect of acyclovir between supported MRI with those unsupported to HSVE. The relationship between cerebral MRI with therapeutic effect of acyclovir in HSVE has less mentioned by far. Investigate the value of MRI as a marker to predict the prognosis of viral encephalitis.Method We have a retrospective investigation in virus encephalitis which have clinical evidence for HSVE from January 2005 to November 2010 at the neurology department of the First Affiliated Hospital of Fujian medical University. There are fifty-two patients (mean age36.52±16.20 years, male /female 24/28). All patients have cerebral MRI. According to MRI, we divide those patients into two groups. One has supported MRI for HSVE (group supported), the other not (group unsupported). There are without differences between two group in level of concisions and the time of initiating of Acyclovir, follow-up time (P>0.05). All patients have standard treatment of Acyclovir .We study the difference between two groups for these clinical data and effects of acyclovir with GOS score (Glasgow Outcome Scale) in short-term and long-term studies. We analysis the measurement data with normal test and t test and count data withχ2 test by SSPS soft ware .It signs difference if P<0.05.Results There are twenty-seven patients (mean age 38.64±13.96years, male/female 12/15) in nonsupport group, including three patients loss. And, twenty-five patients (mean age 27.30±16.98years,male/female 12/13) in group supported including three patients died in acute stage. Most patients in group unsupported have normal MRI and abnormal behavior. Compared to group unsupported, the supported group have lower GOS score in short and long-term study (Ps=0.005, Pl=0.03), and higher mortality(0%vs12%,0%vs9%) which may be lower than those reported before. The disability rate is without difference between two group in short-term study (P>0.05), The GOS score is improved in two group after discharge (P supported=0.005, P unsupported=0.015).Conclusion HSVE with normal MRI may have good reaction to acyclovir. Compared to group unsupported , Group supported had poor prognosis, higher disability rate and higher mortality rate, which; However had lower disability rate and mortality rate compared to previous literature. GOS increased in long term followed up of both two groups. As for the group unsupported, more clinical symptoms was mental anomaly, and cerebral MRI was always normal.