Focal necrotising herpes simplex encephalitis: a report of two cases with good clinical and neuropsychological outcomes.

Two patients with atypical focal necrotising herpes simplex encephalitis are described. They presented with relatively mild clinical disease but despite treatment with acyclovir (10 mg/kg/day for three days in case 1 and 10 days in case 2) they developed dramatic, progressive changes (shown on brain CT) that mimicked space occupying lesions of the temporal lobes. Both patients therefore had a diagnostic and therapeutic temporal lesionectomy followed by further 10 day courses of acyclovir. They subsequently went on to make good clinical and neuropsychological recoveries.