[Prognosis of herpes simplex encephalitis. Retrospective study of 19 cases]

The vital and functional prognoses of 19 patients admitted for herpes simplex encephalitis between rate was 26%, a figure close to those reported in the literature. Death occurred before the 4th month in patients with prolonged coma, and it was due to respiratory disorders. The functional prognosis was favourable in one-half of the survivors, but one-third of these remained with severe neurological and behavioural sequelae, predominantly Korsakoff's syndrome and Klüver-Bucy syndrome. Hemiplegia and aphasia, when present, usually regressed within a few months. The prognosis of herpes simplex encephalitis has improved owing to advances in intensive care and to the advent of antiviral treatments, notably acyclovir the effectiveness of which has been demonstrated by several therapeutic trials. In view of its low toxicity, acyclovir should be tried when the disease is suspected on clinical ground, without waiting for the diagnosis to be confirmed by serological tests; treatment can thus be instituted before the patient becomes comatose.