A comparison of treatment methods for behaviour disorder following herpes simplex encephalitis

Abstract

This study describes the response to treatment of a survivor of herpes simplex encephalitis (HSE) who presented with a dense amnesia, dysexecutive syndrome, and very severe behaviour disturbance that prevented rehabilitation from taking place. Three interventions were used: (1) a behaviour management approach that used a token economy together with “time-out”; (2) an individually designed positive reinforcement programme; and (3) response cost. Only response cost was found to bring about a significant improvement in behaviour. The differing effectiveness of the three interventions are discussed in relation to the load on memory they made, the patient's understanding of the reward contingencies operating, and the degree to which the patient himself was involved in his own treatment.