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Herpes simplex encephalitis (HE) is one of the most common aetiologies of fatal sporadic encephalitis (Whitley, 1990). Although acyclovir has greatly decreased mortality, HE is still associated with significant mortality (19–28%) and morbidity with rates of complete recovery less than 50% (Skoldenberg et al. 1984; Taira et al. 2009). Behavioural and cognitive symptoms are common sequelae of HE, even when appropriate antiviral therapy is administered in the acute stage of the illness (McGrath et al. 1997). Therefore, there is a need for novel therapeutic regimens for HE, given that current available treatment is not fully effective and the scarce available literature suggests benefit with alternative treatments.The effect of drugs on neuroplasticity has received greater attention in psychopharmacology, with recent studies showing that neurotrophic properties may be important for the behavioural and symptomatic effect of mood stabilizers such as valproate and lithium (Frey et al. 2006). Therefore, it could be hypothesized that these pharmacological properties may be useful in the treatment of HE, given that it is often associated with neuronal damage and behavioural symptoms. Here, we report on a 20-yr-old woman with HE and prominent secondary behavioural and manic-like symptoms. To the best of our knowledge this is the first report of HE that was responsive to pharmacotherapy which is the first-line treatment for acute mood episode.Ms. X, a 20-yr-old woman, was admitted to the emergency room with headache, vomiting, cough and dyspnoea; these had gradually developed within the previous 2 wk. Within the first 48 h, Ms. X showed a gradual …

Improvement of behavioural and manic-like symptoms secondary to herpes simplex virus encephalitis with mood stabilizers: a case report