• herpes simplex encephalitis

We read with interest the editorial by Kennedy et al,¹ detailing the short-term treatment of herpes simplex encephalitis (HSE). We agree with the authors that we cannot overemphasise the seriousness of the neuropsychiatric symptoms that a number of these patients display in the long term.

We report a 55 year old woman who was diagnosed with HSE; diagnosis was confirmed with a positive PCR test for herpes simplex in the CSF and acyclovir was started the following day after presentation. After a few weeks the patient’s recovery was almost complete and she was discharged home. Six months later, there was an abrupt change when the patient developed insomnia and would sit up all night watching children’s videos; she also became hostile and confused. She was admitted to a psychiatric unit where she continued to be confused and agitated …