Dexamethasone for viral encephalitis : Is it proven to work
Dexamethasone is a Corticosteroid used in the treatment of many different acute and ongoing medical ailments. This steroid has proven useful in many other situations as an anti-inflammatory however it is still to be decided by much more research and trial as to the effectiveness of Dexamethasone as a reliable treatment for Viral Encephalitis.
What is Viral Encephalitis
In most cases of confirmed Viral Encephalitis the general underlying cause is the Herpes Simplex Virus or HSV. As the virus mutates and reproduces it can travel to the brain and begin to attack the CNS (Central Nervous System). This attack can cause Encephalitis. This is a neurological emergency; with mortality rate of 70% or higher in the United States. (Faculty) Early treatment in any form only reduces this number between 20 and 50%. With a diagnostic rate of 1 out of every 4 people in 1,000,000 people per year HSV Encephalitis is most common in the United States and in most Western Countries. (Faculty) Encephalitis is distinguished from meningitis by distinct qualities; first there is general an altered mental state in most patients, and second there are specific neuro-markers doctors look for in patients exhibiting the altered mental state. HSV Encephalitis untreated can lead to hemorrhaging, edema, and necrosis in the sub-frontal and medial temporal lobes of the brain, with a high probability of neuronal cell death.
What animal and human trials of Dexamethasone has shown
In animal trials with mice the administration of Dexamethasone at the critical onset of HSV Encephalitis has shown to have some neuro protection from the virus. Dexamethasone has shown to control the replication of the virus and has promise in restricting neuronal cell death in the brain. These are both promising conclusions from animal studies (Faculty). A human study with about 45 people has now been conducted with the test patients being in various stages of the viral disease. This study has found that in a greater number of cases administering Dexamethasone in the early onset stages has shown reliability as a predictor of improved outcomes. This is not a hard proven fact as more trials are needed to show this result consistently, however it could be the precursor to a permanent form of treatment in the area of HSV Encephalitis. In this trial Dexamethasone was the only independent predictor which when administered at onset as part of a treatment protocol which could prove somewhat reliable.
No prolonged human trial or study has been completed as of yet, however currently running is the GACHE trail using Dexamethasone. Until the results of this study are in there is not enough verifiable proof that the use of Dexamethasone or any other steroid as standard and recommended treatment of Encephalitis will glean any better results than the current standard of comfort care. Until such evidence and consistency can be documented in the majority of cases Dexamethasone and other steroid treatments will only be tentatively recommended by doctors. (Faculty)
Faculty. (n.d.). Medscape. Retrieved from medscape.org: http://www.medscape.org/viewarticle/569256_5
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