Herpes simplex virus (HSV) encephalitis is the most commonly diagnosed viral encephalitis in the UK. Standard treatment with intravenous acyclovir has greatly improved mortality but survivors are commonly left with significant neuropsychological sequelae and functional disability.

Inflammation and swelling of the brain parenchyma are believed to be major components of the disease mechanism in HSV encephalitis and are linked to poor outcome. The role of corticosteroids in the treatment of HSV encephalitis is unclear but retrospective analyses suggest they may be useful by helping reduce brain swelling.

dexENCEPH is a prospective randomised controlled trial that will aim to compare the outcomes between patients with HSV encephalitis that do or do not receive corticosteroids. Our goal is to show whether corticosteroids make a difference in patient’s neuropsychological sequelae, functional outcome and brain swelling as well as obtain a better understanding of the disease mechanisms in HSV encephalitis.

dexENCEPH is part of the Brain Infections UK portfolio of studies.