Herpes simplex encephalitis in childhood

Abstract

Central nervous system (CNS) infection by herpes simplex virus (HSV) in childhood consists of herpes simplex encephalitis and CNS infections in neonates. Herpes simplex encephalitis in children resembles that in adults, but CNS infections in neonates differs from adult herpes simplex encephalitis in pathogenesis and clinical features. Trans-neuronal transmission by HSV type 1 causes herpes simplex encephalitis both in children and adults, while hematogeneous spread by HSV type 1 or type 2 causes CNS infections in neonates. Mortality of CNS infections by HSV in childhood has been improved since early diagnosis by polymerase chain reaction and anti-viral therapies have been established. However, neurological morbidity has not yet been improved and sometimes HSV infections relapse after the acyclovir therapy. Recently, longer acyclovir therapy with larger doses is recommended for the treatment of CNS infections in childhood.