ENCEPHALITIS - IDENTIFYING THE SPECIFIC CAUSE IS KEY TO EFFECTIVE MANAGEMENT

Acute viral encephalitis and postinfectious encephalomyelitis affect b oth children and adults. Enteroviruses, HSV types 1 and 2, and arbovir uses are the most common causes of encephalitis in the United States; however, the differential diagnosis is broad. History taking and physi cal examination can provide clues to the cause, but the diagnosis is u sually established on the basis of CSF analysis, viral culture, MRI, a nd serologic testing, when indicated. In the future, PCR techniques ma y enhance rapidity of diagnosis. Until the specific cause is identifie d, empirical therapy should be given. Because complications can be sev ere, all patients with encephalitis should be monitored in a facility capable of providing supportive intensive care. Long-term follow-up is important to detect sequelae, particularly in patients with eastern e quine or HSV encephalitis. PGM.