Volume 21, Number 9—September 2015
THEME ISSUE
Emerging Infections Program
CME ACTIVITY - Research
Encephalitis Surveillance through the Emerging Infections Program, 1997–2010
Karen C. Bloch
and Carol A. Glaser
and Carol A. Glaser
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.
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