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Mortality related to herpes simplex virus encephalitis (HSE) dropped dramatically with the systematic initiation of antiviral treatment in encephalitic syndromes. Further efforts need to be taken to reduce long-term morbidity in the survivors. In this regard, the high rate of postencephalitic epilepsy, which is frequently refractory to medical treatment, contributes significantly to the unfavorable clinical outcome of the disease. Seizures during the acute phase of HSE are the main risk for the development of postencephalitic epilepsy. Yet, there are no randomized controlled trials for the management of acute seizures, preventive measures or the ideal duration of antiepileptic treatment. Hence, concepts for the medical treatment of seizures during the acute phase of HSE and postencephalitic epilepsy are eagerly awaited. Epilepsy surgery is a potential treatment option for the latter, but only promising in a subgroup of …