Table 4.

Key Clinical Features and Findings

Subject	Presenting symptoms	Key neuroimaging*	Key EEG	Key CSF (and other laboratory findings)**	Additional Intervention	Anti-Epileptic Medication at Rehab Discharge
1	Headache, then generalized seizure, altered mental status	2 days post-admission (MRI): Swollen gyri in the frontal and temporal lobes, T2 hyperintensities in bilateral basal ganglia, bilateral thalami, and left cerebral peduncle	2 days post-admission: Diffuse slowing	Admission: WBC 23	None	None
2	Fatigue, headache, emesis, then weakness and mental status changes	1 day post-admission (MRI): T2 hyperintensity of the cerebellum	Within first 2 weeks after admission: Diffuse slowing	Admission: WBC 1135, RBC 875; (Nasal swab: + metapneumovirus)	Solumedrol	None
3	Fever and emesis, then generalized seizure, altered mental status	Within 1 week post-admission (MRI): Inflammation mostly affecting the left temporal lobe with additional involvement in the right occipital, right temporal, and left frontal areas	Continuous EEG monitoring days 6–17 after admission: Left frontal spikes	CSF data unavailable; (Serum: + EBV IgG)	Intubated, Thiopental burst suppression, IVIG, Steroids	Phenobarital, Topamax, Keppra
4	Fever, vomiting, headache, abdominal pain, then generalized seizure, altered mental status	1 week post-admission (MRI): Edema in the amygdala and hippocampus consistent with findings of limbic encephalitis; 2 months post-admission: Bilateral hippocampal atrophy	Day of Admission: Diffuse slowing with frontal intermittent rhythmical delta activity (FIRDA); 2 months after admission: Bilateral spikes and intermittent slowing	6 days post-admission: WBC 0	Intubated	Keppra, Depakote
5	Sore throat, fever, malaise, headache, then generalized seizure	5 days post-admission (MRI): Diffuse hyperemia of the cerebrum with multiple small foci of T2-prolongation	Within first week post-admission: Unilateral spikes, diffuse slowing	Day of admission: WBC 45, RBC 139, protein 79	Intubated	Tegretol
6	Generalized seizure, altered mental status	1 day post-admission (MRI): Diffuse atrophy of the cerebrum with relative sparing of the cerebellum and brainstem	Day of admission: Normal prolonged EEG	Day of admission: WBC 1	None	Keppra, Depakote
7	Focal seizure, altered mental status	2 months post-admission (MRI): No abnormalities noted	2 months post-admission: Diffuse slowing with intermittent focal slowing in the left frontotemporal area	2 weeks post-admission: WBC 12	Intubated, Methylprednisone (high dose)	Dilantin
8	Generalized seizure, altered mental status	3 weeks post-admission (MRI): No abnormalities noted	1 day post-admission: Focal slowing on the left; 10 days post-admission: Diffuse slowing	1 day post-admission: WBC 22	Solumedrol	Dilantin, Tegretol
9	Fever then generalized seizure, altered mental status	2 weeks post-admission (MRI): Generalized cerebral edema with mild enhancement of the hippocampi	2.5 months post-admission: Subtle bifrontal or diffuse slowing intermittently	Day of admission: WBC 1, RBC 1800	Plasmapheresis, IVIG, Intubated, Pentobarbital for burst suppression, Solumedrol, Ketogenic diet	Dilantin, Phenobarbital
10	Headache, then generalized seizure, then progressive agitation/aggression	1 month post-admission (MRI): Mild global volume loss	1 day post-admission: Right frontal slowing; 6 days post-admission: Right-sided spikes and slowing and secondary generalized seizure discharges	1 day post-admission: WBC 14	Intubated, Steroids, Plasmapheresis, IVIG	Keprra, Valium
11	Fever, then generalized seizure, altered mental status	1.5 months post-admission: Moderate global atrophy, symmetrical atrophy of the hippocampal gyri but no sclerosis of the temporal lobes	Continuous EEG of first 3 weeks of admission: Consistent with seizure disorder of widespread origin (focal and generalized characteristics); 2 months post-admission: Rhythmic and semi-rhythmic bilateral, anterior maximal slow and sharp-and-slow waves, intermittent diffuse slowing	Day of admission: WBC 17, RBC 263	Intubated, Pentobarbital for burst suppression, Ketogenic diet, Solumedrol, vasopressor support	Topamax, Keppra, Phenobarbital
12	Rash and fever, then headache and vomiting, then fatigue/agitation	Day of admission (CT): Edema of medial right basal ganglia and anterior thalamus, right thalamic and 2 cerebellar lesions	none	Unknown	Intubated, Steroids	None
13	Cognitive/behavioral changes	Day of admission (MRI): Leptomeningeal enhancement over parietal cortex and posterior fossa	2 days post-admission: Diffuse slowing with intermittent 2–3 sec runs of sharp and slow waves predominant (asymmetrical)	Unknown	IVIG	Tegretol

^*Earlier neuroimaging studies, if not commented on in this table, were normal

^**Findings are CSF data, unless otherwise stated

WBC=CSF white blood cell count (per cubic millimeter)

RBC=CSF red blood cell count (per cubic millimeter)