Central nervous system herpesvirus infections

The herpesviridae family are important causes of central nervous system disease in children. We review the spectrum of disease caused by the viruses in the context of a brief description of their epidemiology and transmission. Herpesviridae establish lifelong latency following primary infection and we clearly categorise those diseases associated with primary infection and those associated with reactivation with a particular emphasis on the immunocompromised child. Although a causal association with neurological disease in children is established for HSV and VZV syndromes, we identify the ongoing challenge of establishing causation for other viruses because of the rarity of presentations and viral latency. We review the diagnosis, management and outcome issues with recognition that more research is required.