[Herpes simplex virus infection of the central nervous system]

Herpes simplex virus type 1 (HSV 1) infection in the central nervous system results in encephalitis with high mortality and morbidity. However herpes simplex virus type 2 (HSV 2) infection in this area usually results in benign meningitis. Brain biopsy is the most sensitive and most specific method for diagnosing HSV 1 encephalitis. Antibody determinations in serum and cerebrospinal fluid give only a retrospective diagnosis. A rapid non-invasive diagnostic test is urgently required as an alternative to biopsy. Cerebrospinal fluid viral culture may be of great help in diagnosing HSV 2 meningitis. Acyclovir given intravenously is the treatment of choice for HSV encephalitis. In the case of HSV 2 meningitis no studies have been conducted on systemic antiviral therapy.