Update on HSV and VZV infections of the brain.

ABSTRACT

HSV and VZV are the most frequently identified pathogen in encephalitis cases in France. Recent guidelines were provided by some scientific societies, for the management of encephalitis. PCR is the gold standard for the diagnosis, and the first-line imaging tool is MRI. Sequels are important and there is an absolute need for a better evaluation and management in the future to reduce the short- and long-term consequences, beyond reducing the case fatality rate. A better management of sequels is important. Autoimmune encephalitis triggered by HSV is a recent syndrome, which leads to consider it as a major issue in the management of patients. The final point is the importance of inflammation in explaining disorders and severity, meaning that anti-inflammatory treatments of whatever nature have to be validated.