The Neurological Impediments Connected To Genital Herpes

Highly responsible for neurological indisposition, genital herpes has managed to affect over 40 million individuals in the United States of America. This mind-boggling high number is said to be increasing at the rate of a million per year! Varicella zoster virus, herpes simplex virus type 1 and herpes simplex virus type 2, all have an impact on the patient’s nervous system. Below, we are talking about this in details:

The Initial Infection

Neurological diseases that are connected to genital herpes may get triggered due primary infection or the reactivation of the dormant genital herpes virus. Primary genital herpes in adolescents and adults can be void of symptoms, which is why they usually have no clue about it.

Dormancy and Reactivation

It is said that the neurons in the sacral ganglia are where the virus lies dormant. Although only the reactivation of oral herpes has only been studied so far, experts assume that the mechanism of that of genital herpes will not be too different. Dormant herpes infections reactivate with the help of systemic stimuli, via pathways that still have not been discovered or understood. It has been observed that most people struck with genital herpes shed a certain amount of the herpes virus, regardless of the reactivation of the virus.

The Neurological Difficulties

Not only is the meninges affected by the genital herpes virus by the occurrence of meningitis, the brain, nerve roots, retina, cranial nerves, etc. are affected too.

  • Neonatal Encephalitis
    About 70% of the infants that are infected by herpes are born to women who not only unaware of the fact that they had herpes, but also never showed any signs of the disease. At least 30% of the cases of herpes among infants are just oral herpes. There are several factors that prove to be risky for neonates, starting from the age of the mother to time during when the mother contracted herpes herself. Distribution of the virus to the central nervous system occurs in 70% of the herpes struck infants. Dispersed intravascular coagulations, skin lesions and unusual liver operation are observed in many of these neonates. Cranial MRIs show edema, then cystic encephalomalacia.
  • Recurrent Aseptic Meningitis Among Adults:
    This occurs due to herpetic mucocutaneous disorder, regardless of the presence of symptoms. From 19% to 42% patients experience meningitis with the first episode of type 2 herpes. Suppressive therapy could be used in this scenario: patient could take famciclovir, acyclovir sodium and valacyclovir hydrochloride. Many of these meningitis patients are known to complain about bad headaches, besides phases of total confusion.
  • Radiculopathy:
    40% of sacral dorsal root ganglia are seen having a latent form of herpes simplex virus type 2. This matter was unearthed during the autopsy of several individuals. Radiculopathy that is caused by genital herpes happens to affect specific areas, such as the sacral or lumbar nerve roots. Radiculopathy causes pain, leg weakness, constipation and even urinary retention. Radiculopathy could be cured in a matter of days or weeks, and could be hurried with the intake of antiviral drugs.
  • Retinal Necrosis:
    Shown with the presence of impaired vision and red eye, retinal necrosis seems to affect genital herpes patients (with a median age of about 20 years) and mostly older people. When examined properly, retinal necrosis shows retinal detachment, keratic precipitates and scleritis.
  • Ascending Myelitis:
    This is seen mostly in patients who have a weakened immune system, especially those who have already contracted the HIV virus. Along with pain and lesions, ascending myelitis also shows enlargement of the lower cord of the spine, added with limb numbness.
  • Cranial Neuropathy:
    The dysfunction of the cranial nerves leads to Bell’s palsy, a form of facial paralysis. Even though there are experts who argue that Bell’s palsy cannot occur due to genital herpes, there are others who accept that varicella zoster virus and herpes simples type 1 virus do in fact cause Bell’s palsy. Whoever has such cases are recommended to take antiviral drugs everyday.

Connection Between Genital Herpes and HIV

Recent studies have found a connection between genital herpes virus and HIV. It seems that if you have genital herpes, there is twice or thrice the chance of you acquiring HIV too. Moreover, if you do have genital herpes and you are taking antiviral drugs as part of suppressive therapy, the RNA levels of HIV will show a significant drop too.

Treatment

Vidarabine phosphate was actually the first agent that showed efficacy when it came to treating herpes. After two large studies done on acyclovir, it was chosen as part of standard treatment/therapy for all herpes patients. An oral intake of valacyclovir is also recommended, along with the acyclovir.

Infants could take acyclovir sodium, while patients of meningitis, radiculitis and myelitis could have it too.

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