http://treatmentforgenitalherpes.org/ <br />In adults with HSV-1, the most common early symptoms are headache and fever. Additional symptoms include intellectual impairment, aphasia, meningeal signs, seizures, and paresthesias. Early treatment is crucial to a good outcome, and empirical acyclovir therapy can be initiated before a definitive diagnosis is established. <br />The virus cannot be cultured routinely from CSF, though lymphocytic pleocytosis and elevations in protein concentrations are observed. CSF viral cultures are positive for HSV in fewer than 5% of patients. Anti-HSV antibodies often do not appear until 1-3 weeks after symptom onset; therefore, antibody culture is helpful only in retrospective diagnosis. <br />EEG also can reveal focal temporal abnormalities, which are seen in 80% of patients; a normal EEG is believed to exclude the diagnosis. Periodic lateralized epileptiform discharges also support the diagnosis, but this finding is nonspecific. Historically, a brain biopsy provided
