Diagnostic and therapeutic approach to the patients with acute encephalitis

Abstract

Encephalitis is associated with high morbidity and mortality, and the neurologic manifestations of this condition include fever, headache, altered mental status, convulsions, and psychiatric symptoms. Early diagnosis of encephalitis is crucial to ensure that the right treatment is given on time. Herpes simplex virus was the most common infectious cause among acute encephalitis, followed by varicella zoster virus. Thus, more than a quarter of patients were potentially treatable with aciclovir. Recent repots have showed the increasing recognition of autoimmune encephalitis, and anti–NMDAR encephalitis was the most common autoimmune condition. In this article, the author describes the characteristic clinical findings, magnetic resonance imaging and spinal fluid analysis of herpes simplex encephalitis, varicella zoster encephalitis, and anti–NMDA receptor encephalitis. Early identification of these patients may allow timely initiation of aciclovir and/or immunomodulatory therapy, and help improve clinical outcomes.