The treatment of herpes encephalitis

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Abstract
Herpes encephalitis often presents as an acute necrosis of the brain, brought about by replication of herpes simplex in central nervous system tissue, perhaps associated with an immunological reaction of some vigour. Three pyrimidine analogues are known to inhibit replication of the causative virus and can be used systemically. Sound critical evidence for the value of these drugs is lacking but idoxuridine appears too toxic for it to be recommended, and cytarabine presents conflicting results which only the results of the present United Kingdom trial may dispel. Preliminary results of a U.S. trial suggest that vidarabine, or one of its more soluble derivatives, is likely to find increasing use. Whatever the drug used, the prognosis in herpes encephalitis is markedly influenced by the quality of general medical and nursing support and by reducing cerebral oedema.

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