TY - JOUR
T1 - Epidemiology and outcomes of acute encephalitis
AU - Venkatesan, Arun
N1 - Publisher Copyright:
© 2015 Wolters Kluwer Health, Inc.
PY - 2015/6/6
Y1 - 2015/6/6
N2 - This review seeks to describe recent advances in the epidemiology, outcomes, and prognostic factors in acute encephalitis. Recent findings Infectious causes continue to account for the largest proportion of encephalitis cases in which a cause is identified, although autoimmune causes are increasingly recognized. Type-A gamma-aminobutyric acid (GABA a) receptor antibodies have been recently identified in encephalitis with refractory seizures, whereas the roles of antibodies to the glycine receptor and dipeptidyl peptidase-like protein 6 have been defined in progressive encephalomyelitis with rigidity and myoclonus. Recent findings in the US cases of encephalomyelitis presenting with acute flaccid paralysis raise the possibility that enterovirus D68, a common respiratory pathogen, may cause central nervous system disease. Mortality from acute encephalitis occurs in about 10% of cases, with a large proportion of survivors suffering from cognitive or physical disability. In addition to delay in institution of appropriate antiviral or immune therapy, several potentially reversible factors associated with poor prognosis have been identified, including cerebral edema, status epilepticus, and thrombocytopenia. Summary Encephalitis imposes a significant worldwide health burden and is associated with poor outcomes. Supportive treatment and early institution of therapy may improve outcomes. Careful neurocognitive assessment of survivors of encephalitis is needed to better define long-term outcomes.
AB - This review seeks to describe recent advances in the epidemiology, outcomes, and prognostic factors in acute encephalitis. Recent findings Infectious causes continue to account for the largest proportion of encephalitis cases in which a cause is identified, although autoimmune causes are increasingly recognized. Type-A gamma-aminobutyric acid (GABA a) receptor antibodies have been recently identified in encephalitis with refractory seizures, whereas the roles of antibodies to the glycine receptor and dipeptidyl peptidase-like protein 6 have been defined in progressive encephalomyelitis with rigidity and myoclonus. Recent findings in the US cases of encephalomyelitis presenting with acute flaccid paralysis raise the possibility that enterovirus D68, a common respiratory pathogen, may cause central nervous system disease. Mortality from acute encephalitis occurs in about 10% of cases, with a large proportion of survivors suffering from cognitive or physical disability. In addition to delay in institution of appropriate antiviral or immune therapy, several potentially reversible factors associated with poor prognosis have been identified, including cerebral edema, status epilepticus, and thrombocytopenia. Summary Encephalitis imposes a significant worldwide health burden and is associated with poor outcomes. Supportive treatment and early institution of therapy may improve outcomes. Careful neurocognitive assessment of survivors of encephalitis is needed to better define long-term outcomes.
KW - Acute flaccid paralysis
KW - autoimmune encephalitis
KW - herpes simplex virus
KW - prognosis
KW - viral encephalitis
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U2 - 10.1097/WCO.0000000000000199
DO - 10.1097/WCO.0000000000000199
M3 - Review article
C2 - 25887770
AN - SCOPUS:84929457923
SN - 1350-7540
VL - 28
SP - 277
EP - 282
JO - Current opinion in neurology
JF - Current opinion in neurology
IS - 3
ER -