E-Poster Abstracts Electroencephalogram (EEG) P-EG001. The role of EEG in Herpes Simplex Encephalitis (HSE): An experience of two distinct EEG findings from DR Sardjito general hospital Yogyakarta Indonesia

• Published in: Clinical neurophysiology 2021-08, Vol.132 (8), p.e78-e78
• Main Authors: Nur Salim Winarno, Agus, Satiti, Sekar, Pambudi Sejahtera, Desin, Fithri Khairani, Atitya
• Format: Article
• Language: English
• ISSN: 1388-2457; 1872-8952
• DOI: 10.1016/j.clinph.2021.02.161

Introduction. Encephalitis is considered as neurological emergency because it can result in death or severe disability. HSE is the most common form of encephalitis and it risks to serious condition and can be fatal if untreated properly. Precised diagnosis and treatment is a key to reduce its mortality and morbidity. EEG is one of ancillary examination to support diagnosis and management of HSE, but its exact role is unclear. Results. We describe two cases of HSE that admitted to our neurology ward. Each case has two distinct EEG results. In case number 1, there was a 40-year-old male came with acute seizure, behavioral changes, and intermittent fever. The history, physical exam, laboratory, lumbar puncture, brain MRI with contrast led to diagnosis of HSE. He also underwent EEG which result was periodic lateralized epileptiform discharge (PLED). He had acyclovir and phenytoin medication. In day 14, he was discharged. In case number 2, there was a 47-year-old female came with reduced consciousness, recurring seizure, and fever. The history, physical exam, laboratory, lumbar puncture, brain MRI with contrast led to diagnosis of HSE. She also underwent EEG which result was focal continuous polymorphic delta (CPD) slowing. She had acyclovir and phenytoin medication. In day 16, she was discharged. Two weeks later, EEG was conducted and the result was normal. Conclusion. EEG is the most accessible and inexpensive diagnostic tool for evaluation of CNS function. EEG might be useful in the acute stage of HSE. It is more sensitive than CT but its specificity is low. It has benefit to determine the diagnosis of HSE, presence of seizure, treatment, and prognosis. PLED and focal CPD slowing are characteristic finding of EEG in HSE but they are not pathognomonic. It is needed to consider other clinical data in order to achieve final decision making.