Psychiatric and behavioral symptoms after pediatric herpes simplex virus type 1 encephalitis: An exploratory case series

Aim: To exploratively describe long-term psychiatric and behavioral symptoms in pediatric survivors of herpes simplex virus type 1 encephalitis. Methods: In this retrospective descriptive case series conducted at two tertiary pediatric centers, admissions from 2000 to 2022 were screened for confirmed herpes simplex virus type 1 encephalitis. Eight families completed validated parentand self-report questionnaires assessing emotional and behavioral symptoms. Analyses were descriptive. Results: Mean age at disease onset was 5.4 years, and mean age at follow-up was 13.1 years. Seven of eight children exhibited persistent neurological sequelae. Clinically elevated emotional or behavioral symptoms were observed in a subset of children, including anxiety, depressive symptoms, and attention problems. Conclusions: Some pediatric survivors exhibited clinically relevant emotional and behavioral symptoms years after the acute illness. Although no conclusions regarding prevalence or disease-specific risk can be drawn, the findings underscore the importance of clinical awareness and mental health screening as part of long-term follow-up care.