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Generally, herpes it is not life-threatening and has no long-term repercussions on one’s general physical health. However, there is a rare condition called Encephalitis which can cause complications.

What is Herpes Encephalitis?

Encephalitis is a condition where the brain becomes inflamed due to a virus or other types of infections. One kind of virus that can cause encephalitis is Herpes simplex type 1 (HSV-1).

Although Herpes simplex type 1 most often causes mild symptoms like cold sores and fever blisters, it can occasionally travel to the brain and cause encephalitis.

This condition is extremely rare

Herpes encephalitis is very rare, affecting two cases per million among the U.S. population.

Herpes simplex I is a very common virus that can cause small blisters or “cold sores” on the lips, inside the nose, in the eye, or on the eyelid. Very rarely, it is possible for the virus to move to the brain.

The virus can move from the nasal cavity up into the sinuses, and then into the brain. This can result in encephalitis. It is diagnosed by detecting HSV DNA in a spinal tap and treated with intravenous acyclovir.

Signs and Symptoms

The symptoms of herpes simplex encephalitis can include a sore throat, fever, headache, a stiff neck, runny nose and vomiting.

As the disease progresses, more serious symptoms such as personality changes, paralysis, hallucinations, convulsions, and coma can occur. If left untreated, herpes encephalitis can result in death.

If you suspect that you have herpes encephalitis, it is very important that you contact your healthcare provider immediately. Proper diagnosis and prompt treatment are necessary.

Where to Now?

Ask questionsAsk questions and get support right now in the Herpes Support Forum


This Post Has 4 Comments
  1. I have been getting cold sores on my nose tip and just inside my nose recurring about once or twice a month for over a year. This morning I woke to discover it had migrated much further up this time, and is coming in on my sinus. It is incredibly painful and itchy. Thank you for the informative articl. I will be going to the doctor today.

  2. Hi everyone

    I have had herpes simplex keratitis (ocular) since I was 13 months old. I am now 25.
    My experience when I was young was horrible. My eyelids and surrounding area would be swollen and infected for 1 week out of the month. It re-occured constantly, but with time the infection rate deteriorated to seasonal intervals by 8yo, then to only periods of high stress/sickness etc by puberty. Now I am an adult it is less commonly triggered, and usually comes on when my comprised immune system, I am highly stressed (I have anxiety/depression too which doesn’t help) or when I get the flu real bad.

    Prior to an eye flare up I get some tell tale warning signs such as sore throat, heavy fatigue, and often I will get a herpes breakout on the tip of my nose, which travels up the nasal cavity causing pussy blisters inside my nostril, which is very painful and ugly embarrassing. Often they rupture with puss and some blood, and is severely worsened by dirt and wind. If you get this stay indoors as the cold air and wind WILL make it much worse and MUCH more painful. When it occurs on my nose I will take Acyclovir to try and prevent it further spreading, although it doesn’t always stop it from flaring up my eye.

    When my eye then flares up, on day 1 I will have no swelling, but a painful stinging sensation over the eyelid, often to one side of the eye only. It kinda feels like bad sinus behind your eye.
    Day 2 – the eyelid will begin to swell, and rapidly if you don’t get strong anti-virals quickly.
    Also good to note It is very contagious so stay away from others – especially young children.
    Day 3 – the swelling begins to make fully opening the eye difficult, it become very red and dots begin to appear. GO TO DOCTORS AT THIS STAGE IF YOU HAVEN’T ALREADY.
    Day 4/5 – usually I’ve stopped it before now with a combination of Valtrax 1000mg & Zovirax Eye Ointment (the prescription version, not the over the counter stuff). Before Valtrax 1000mg was available to my I only had access to the Zovirax eye ointment which helped with the infection, but didn’t slow the progression. So on day 4/5 the little red dots from the day prior, have manifested into yellow blisters. With swelling still present, and nerve endings all open and now blisters this is quite painful, so much so I can’t look at bright lights, look at a computer screen etc. and the worst thing is you can’t even put an eye-patch over it because that severely increases the chance of the infection travelling from the eyelid into the eye.
    Day 5/6 – Blisters often start to burst OWW, but all the antiviral drugs etc should be starting to slow the speed of the damn thing. Often because of the bursting blisters you develop a crust over your eye. I would like to say its like conjunctivitis in a way, and for this it is a good idea to get some sort of topical antiseptic eye cream. Now we are up to 3 drugs, and it gets any worse (and you will know!) I go straight to hospital for IV, but all but 3 times, has it been fine, and symptoms stay same for another day and then start to go away and heal.

    I am lucky in a way, because I had had it for such a long time I know just how quickly you need to act, and the importance of how quickly you need to act. This is a very fast aggressive virus and it is very dangerous to get on your eye if you do not treat it immediately, as if it gets in your cornea you risk permanent damage/blindness.
    If you have had any cold sores/blisters on lids/tongue/mouth/nose etc in the past week or two and then you think you’re getting conjunctivitis, their is a chance it is the herpes virus that has moved to your eye. Your doctor may think its just conjunctivitis, however if you had any cold sores in last 2 weeks, or you are concerned you do have Herpes Simplex Ocular get a second opinion immediately or go to the ER department to see an eye specialist.

    I have had doctors tell me its conjunctives before and I KNOW its the herpes as it happens to me ALL THE TIME, I’ve told them this and they’re like “its OK, I’ve seen conjunctivitis plenty of times and it should clear up in a few days with a topical antibiotic eye ointment” – THIS IS WRONG, IT RISKS SPREADING IT INTO THE EYE IF YOU ARE NOT TAKING ANTIVIRALS. I think a lot of doctors have not seen this on the eye, and they say to come back if symptoms get worse, or you may even get one that sends you to hospital straight off the bat (happened twice and I know what I need to stop it, they didn’t give me drugs and sent me to hospital… I waited 8 hours to see someone and the blisters got worse in that time, they gave me the drugs I initially asked for and then sent me home 🙁
    .. if they try and pass it off and you are concerned or had symptoms of cold sores elsewhere the best advice I can give you is GO TO ANOTHER DOCTOR. This is one thing that needs immediate action.

    Good luck!

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