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Herpes meningitis is typically self-limiting over 2 weeks without treatment. However, empirical use of antiviral medications such as acyclovir are considered in cases of suspected HSV meningitis to prevent progression to the more rapid and fatal HSV meningoencephalitis. [7] HSV-2 is the most common herpes virus that causes meningitis. [3]
About 90% of cases of herpes encephalitis are caused by herpes simplex virus-1 (HSV-1), the same virus that causes cold sores. According to a 2006 estimate, 57% of American adults were infected with HSV-1, [ 3 ] which is spread through droplets, casual contact and sometimes sexual contact, though most infected people never have cold sores.
Encephalitis with meningitis is known as meningoencephalitis, while encephalitis with involvement of the spinal cord is known as encephalomyelitis. [ 2 ] The word is from Ancient Greek ἐγκέφαλος , enképhalos 'brain', [ 37 ] composed of ἐν , en , 'in' and κεφαλή , kephalé , 'head', and the medical suffix -itis 'inflammation'.
HSV-2 is the most common cause of Mollaret's meningitis. [83] HSV-1 can lead to potentially fatal cases of herpes simplex encephalitis. [84] Herpes simplex viruses have also been studied in the central nervous system disorders such as multiple sclerosis, but research has been conflicting and inconclusive. [85]
A very specific exception is herpes simplex virus (HSV) encephalitis, which can be treated with acyclovir for 2 to 3 weeks if it is provided early enough. Acyclovir significant decreases morbidity and mortality of HSV encephalitis and limits the long-term behavioral and cognitive impairments that occur with illness.
Aciclovir acts by inhibiting viral DNA replication and is used for the treatment of herpes simplex virus (HSV) and varicella zoster virus infections, including: [3] [15] [16] Genital herpes simplex (treatment and prevention) Neonatal herpes simplex; Herpes simplex labialis ; Shingles; Acute chickenpox in immunocompromised patients
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