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Acute encephalitis
1Department of Neurology, Aarhus Kommunehospital, Denmark.
Abstract:
Acute encephalitis: etiology, clinical findings and prognosis. We studied 44 patients with acute encephalitis diagnosed in a neurological university clinic during an 11-year period. An etiology was found in 11 cases (25%). In 3 the cause was herpes simplex virus; in 2 morbilli. There were single patients in which the cause was mycoplasma pneumoniae, epidemic parotitis, ornithosis, infectious mononucleosis, influenza B-virus and recent tetanus immunization. No specific etiology was found in 33 (75%). Besides fever the most frequent sign was impairment of consciousness in 39% of cases. Four patients (9%) died. Among the survivors mental and/or focal neurological deficits persisted in 22 (55%). Most frequent was dementia in 6 cases (15% of survivors). Impaired consciousness in the acute phase indicated a worse prognosis (p < 0.005).
Insights
Identifying the cause of acute encephalitis is challenging, with only 25% of cases having a determined etiology. Impaired consciousness during acute encephalitis significantly worsens the prognosis for patients.
Area of Science:
- Neurology
- Infectious Diseases
- Clinical Medicine
Background:
- Acute encephalitis is a severe neurological condition with diverse potential causes.
- Etiological diagnosis remains a significant challenge in managing encephalitis cases.
- Understanding clinical presentations and prognostic factors is crucial for patient outcomes.
Purpose of the Study:
- To investigate the etiological spectrum of acute encephalitis.
- To describe the clinical findings associated with acute encephalitis.
- To determine the prognostic indicators for patients diagnosed with acute encephalitis.
Main Methods:
- Retrospective analysis of 44 patients diagnosed with acute encephalitis over an 11-year period.
- Etiological investigations included viral, bacterial, and atypical pathogen testing.
- Clinical data collection focused on symptoms, neurological status, and patient outcomes.
Main Results:
- A specific etiology was identified in only 25% of cases, with Herpes Simplex Virus being the most common identified cause.
- Impairment of consciousness was the most frequent clinical sign (39%).
- Mortality was 9%, and 55% of survivors experienced persistent neurological deficits, most commonly dementia (15% of survivors).
Conclusions:
- A significant proportion of acute encephalitis cases remain without a specific etiological diagnosis.
- Impaired consciousness in the acute phase is a strong predictor of a poorer prognosis.
- Early identification of prognostic factors is essential for effective patient management and care.