PROTRACTED FORM OF ENCEPHALITIS WITH GOOD OUTCOME

Objective: To present four patients seen over a five-year period who d eveloped severe protracted encephalitic illnesses but whose outcomes w ere favourable. Clinical features: Of the four patients, aged 18, 22, 34 and 19, three presented with acute psychosis, and all had a prolong ed clinical course requiring intensive care management. One patient ha d residual generalised seizures and the other three recovered fully. N o infective or toxic agent could be identified but viral encephalitis was considered most likely. Outcome: Despite the protracted courses, t he outcomes were favourable. This is in contrast to the generally poor outcomes in encephalitis caused by established infective agents such as herpes simplex type 1. Conclusions: When the aetiology and hence th e natural history of the encephalitis is unknown, long-term intensive support is appropriate.