Herpes simplex virus type-1 (HSV-1) may lead to a variety of neurological disease, mainly encephalitis. The aim of this study was to present the different infectious and postinfectious disorders of nervous system due to HSV-1.

Eleven patients who had infectious (encephalitis, HSE; acute hemorrhagic leukoencephalitis, AHL) and postinfectious disorders (subacute sclerosing panencephalitis, SSPE; optic neuritis; Guillain-Barre syndrome, GBS) due to HSV-1 were enrolled to study. Patients were evaluated by clinically, laboratory testing, and radiological studies. The mean age of patients was 7.86±3.1 years. Among them six (54.5%) were female and five (45.5%) male. Fever (n=11, 100%), mental confusion / loss of consciousness (n=9, 81.8%), and seizures (n=5, 45.5%) were the most common complaints. On the physical examination fever (n=11, 100%), impaired consciousness (n=9, 81.8%), and neurological deficits (n=5, 45.5%) were detected. HSV-1 antibodies by ELISA and / or HSV-1 DNA by PCR performed on serum and cerebrospinal fluid of all patients yielded as positive. Diagnosis of HSE was described in eight of them, and AHL, GBS / optic neuritis, and SSPE due to HSV-1 in each one, respectively. On the radiological studies fronto-parieto-temporal areas were the mainly affected sites. While only three patients (27.3%) fully recovered; other patients died (n=3, 27.3%) or recovered with neurological sequelas (n=5, 45.5%).

HSV-1 may be associated with a variety of neuropathological conditions (AHL, GBS, optic neuritis, and SSPE) other than encephalitis. Therefore, HSV-1 should be considered in the differential diagnosis of these conditions.