Background and Purpose: Herpes Simplex Encephalitis 
(HSE), the most common cause of sporadic viral 
encephalitis, causes permanent neurologic deficits and 
disablement in many affected individuals. To our 
knowledge, there have been no published studies that have 
examined any aspects of rehabilitation for individuals with 
HSE. The purpose of this case report was to investigate the 
effects of a physical therapist directed rehabilitation 
program to improve balance and gait in an individual with 
severe ataxia and imbalance secondary to HSE.  
Case Description: A 25-year-old male with acute vestibular 
neuritis and diffuse cerebellitis caused by HSE presented to 
an inpatient rehabilitation hospital with nystagmus, motion 
sensitivity, trunk tremoring, and balance and coordination 
problems that impaired his ability to transfer, walk, and 
perform his daily life activities.  
Intervention: The individual participated in an intensive 17 
day, six day per week physical therapy program, consisting 
of eye-head coordination and habituation exercises, balance 
training, and functional task practice.  
Outcomes: Outcome measures used were the Functional 
Independence Measure (FIM), Berg Balance Scale (BBS) 
and the Brief Ataxia Rating Scale (BARS). Improvements 
were noted in all outcome measures (pre to post); the patient progressed from a 0/56 to a 49/56 on the BBS and from 
an 18/30 to a 7/30 on the BARS. Improvements in sitting 
balance, transfers, and walking enabled the patient to 
return home with assistance from his parents for driving 
and some fine motor tasks.  
Discussion: Physical therapy may improve balance and 
mobility for patients with cerebellar and vestibular 
pathologies secondary to HSE.