The computed axial tomograph in acute herpes simplex encephalitis

If there is to be any benefit from the treatment of herpes simplex encephalitis, diagnosis must be made early on in the disease, possibly even within the first 48 hours. A major difficulty arises because many of the patients do not develop symptoms and signs severe enough at an early stage to warrant a brain biopsy, which is often the only method of establishing a definite diagnosis. By this method the virus can usually be recognized by immunofluorescence studies, electron microscopy or virus culture. Prior to this the presence of a sterile lymphocytosis in the cerebrospinal fluid and slow wave activity on the EEG with increased spikes may suggest the diagnosis, and special radiological studies may be of considerable further assistance.