Herpes simplex encephalitis (HSE) followed a biphasic course with relapse in 3 children aged 11 years, 9 months, and 11 months reported from the Hospital for Sick Children, London and South Hampton General Hospital, England. All 3 presented with fever and seizures and relapse was accompanied by generalized or hemi-chorea in 2 patients. All patients received repeat courses of acyclovir, antibiotics and anticonvulsants. Dexamethasone was added in the older patient and the acyclovir course was followed by vidarabine in 2 patients. All patients had residual sequelae at discharge: 1 had a mild right facial weakness and persisting dysphasia, another was severely handicapped with persisting chorea and a third was visually inattentive and had a right hemiplegia and left hemichorea. The cause of the relapse was not definitely determined. A possible resistant organism might indicate a longer initial course of high dose acyclovir or alternatively, a post-infectious neuroallergic process might suggest the substitution of immunomodulatory treatment in place of further antiviral treatment. 
COMMENT. Relapsing herpes simplex encephalitis is not uncommon in adults but is rare in children. Chorea in association with HSE relapse is of interest. The authors refer to 7 additional patients reported in the literature.
Autism is another unusual sequel to herpes simplex encephalitis described in a 31 year old adult at the University of Goteborg, Sweden . Other cases in the literature have occurred in pre-adolescence. Autism is not necessarily a developmental disorder and temporal lobe damage caused by herpes encephalitis may explain some cases. The Kluver-Bucy syndrome, characterized by emotional instability, hypersexuality and hyperorality, has also been described as a complication of herpes encephalitis when both temporal lobes have been involved.