Cerebrospinal fluid

Intensive care medicine

Aciclovir

Herpesviridae

Viral disease

Virology

Psychiatry

Autoimmune encephalitis

Lumbar puncture

Immunology

Pediatrics

Herpes simplex virus

Encephalitis

Electroencephalography

Medicine

Virus

Pathology

Viral encephalitis

Clinical Medicine

<h3>ABSTRACT</h3> Encephalitis, inflammation of the brain, is most commonly caused by a viral infection (especially herpes simplex virus [HSV] type 1 in the UK) although autoimmune causes, such as N-methyl D-aspartate receptor (NMDAR) antibody encephalitis, are increasingly recognised. Most patients present with a change in consciousness level and may have fever, seizures, movement disorder or focal neurological deficits. Diagnosis hinges crucially on lumbar puncture and cerebrospinal fluid (CSF) examination, but imaging and electroencephalography (EEG) may also be helpful. Treatment of HSV encephalitis with aciclovir dramatically improves outcome, but the optimal management of autoimmune encephalitis is still uncertain. Many patients with encephalitis are left with residual physical or neuropsychological deficits which require long-term multidisciplinary management. Here we review assessment of patients with suspected encephalitis, general aspects of management and areas of ongoing research.

Acute encephalitis – diagnosis and management