TABLE 1.

Case reports and series of patients with HSE treated with corticosteroids alone or in combination with acyclovir^a

Reference	Brain involvement, clinical sign(s), or patient group	Age	Single or combined therapy and dose(s)	Clinical outcome	Neurological disability or outcome
185	Both hemispheres	35 mo	DEX at 8 mg i.v. and then at 4 mg i.v. 4× daily for 17 days	Improved	Mild
	Meningoencephalitis	20 mo	DEX at 2 mg i.v. and then at 2 mg i.m. 4× daily for 3 days	Improved	Moderate
186	Right temporal lobe	35 yr	Hydrocortisone at 200 mg i.v. for 10 days	Improved slowly	Mild
	Right temporal lobe	70 yr	Hydrocortisone for 30 days	Improved	Severe
187	Left temporal lobe	20 yr	DEX at 5 mg 4× daily for 7 days	Improved	Mild
	Left temporal lobe	32 yr	DEX at 5 mg 4× daily for 7 days	Improved slowly	Severe
188	Right temporal lobe	47 yr	Adrenal corticosteroids, high dose i.v.	Improved	Recovered
	Right temporal lobe	50 yr	Adrenal corticosteroids, high dose, + IDU	Improved	Recovered
189	23 patients with HSE from the literature and personal cases	5 mo to 77 yr	ACTH at 40–80 U daily or cortisone at 75 mg daily or hydrocortisone at 300–400 mg daily or prednisolone at 40 mg daily or DEX at 16–20 mg daily	7 improved, 7 improved with IDU, 2 improved slowly, 7 no change	12 recovered, 1 severe, 10 died
190	Acute encephalopathy with bilateral striatal necrosis	4 yr	Prednisolone at 30 mg i.v. 1× daily for 30 days; 5 days after initiation of prednisolone, ACV at 10 mg/kg i.v. 3× daily for 14 days	Improved	Recovered
191	Focal edema in bilateral parieto-frontal lobes, cerebellum, and left thalamus	16 mo	ACV at 1,500 mg/m2 i.v. for 21 days; 9 days later, methylprednisolone pulse therapy i.v. at 1 g/1.7 m2 for 3 days	Improved	Mild
192	Right temporal lobe	30 yr	ACV at 750 mg i.v. 3× daily for 21 days; DEX at 10 mg 4× daily for 4 days	Improved	Recovered
193	Five patients with altered consciousness, tremor, rigidity, and seizure		ACV at 1,500 mg/day i.v. plus methylprednisolone at 1,000 mg/day i.v. for 3 days, started 5 days after onset of disease (3/5 patients)	3 improved	3 recovered
			ACV at 1,500 mg/day i.v. plus methylprednisolone at 1,000 mg/day i.v. for 3 days, started 3 weeks after onset of disease (2/5 patients)	2 no change	2 died
194	Case series of 6 patients with HSE	4 mo to 10 yr	ACV at 15 mg/kg 3× daily for 21–28 days (3 patients)	3 improved	2 severe, 1 mild
			ACV at 15 mg/kg 3× daily for 21–28 days (3 patients) plus pulse steroid methylprednisolone at 30 mg/kg/day for 1–3 days, followed by methylprednisolone orally for 2 weeks (2/6 patients), or prednisolone at 2 mg/kg/day i.v. (1/6 patients)	3 improved	3 mild
195	Case series of 45 patients with HSE	17 yr to 77 yr	ACV at 10 mg/kg 3× daily for 14 days (23/45 patients)	13 poor outcome, 10 good outcome	8 recovered, 2 mild, 2 moderate, 6 severe, 5 died
			ACV at 10 mg/kg 3× daily for 14 days plus DEX or prednisolone at 40–96 mg/day for 2 to 42 days (22/45 patients)	6 poor outcome, 16 good outcome	6 recovered, 10 mild, 6 moderate

^aACTH, adenocorticotropic hormone; ACV, acyclovir; DEX, dexamethasone; IDU, idoxuridine; i.m., intramuscular; i.v., intravenous; HSE, herpes simplex virus encephalitis; ×, times. Mild, moderate, and severe describe neurological disabilities.