Table 3. Emerging Infections Program Encephalitis Project clinical profiles, 1997–2010*.
Clinical profile | Patient description | Comments |
---|---|---|
Focal | ||
Temporal lobe | Temporal lobe enhancement on imaging or activity on EEG | HSV accounted for approximately one third of cases |
Extrapyramidal | Movement disorder | Measles (SSPE), autoimmune encephalitides |
Cerebellar
|
Ataxia or gait disorder, or focal cerebellar lesion on imaging |
Acute EBV infection seen in a minority of cases |
Generalized | ||
Cerebral edema | Neuroimaging showing diffuse brain edema | Deaths exceed 70% |
Intractable seizures | Seizures requiring anesthetic coma for management | Majority of case-patients: pediatric patients with prolonged hospitalization |
Seizure with rapid recovery | Onset with seizure and return to baseline mental status in <96 h | CSF typically bland; Bartonella spp. most common cause (cat-scratch encephalopathy) |
Psychosis | New onset of prominent psychiatric symptoms | Anti-NMDAR antibodies common in this syndrome |
*EEG, electroencephalogram; HSV, herpes simplex virus; SSPE, subacute sclerosing panencephalitis; EBV, Epstein-Barr virus; NMDAR, anti-N-methyl-D-asparate receptor.