Table of contents
Encephalitis
Guidelines
Key sources
The following summarized guidelines for the evaluation and management of encephalitis are prepared by our editorial team based on guidelines from the Association of British Neurologists (ABN/BIA 2012), the Association of British Neurologists (ABN/BPAIIG 2012), and the Infectious Diseases Society of America (IDSA 2008).
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Screening and diagnosis
Diagnostic investigations
Clinical assessment: as per IDSA 2008 guidelines, assess for epidemiologic clues and risk factors to identify potential etiologic agents in patients with encephalitis.
B
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Evaluation for infectious etiology
Neuroimaging
Electroencephalography
Diagnostic procedures
Lumbar puncture: as per ABN/BIA 2012 guidelines, perform lumbar puncture as soon as possible after hospital admission in all patients with suspected encephalitis, unless there is a clinical contraindication.
B
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Brain biopsy
Medical management
Setting of care: as per ABN/BIA 2012 guidelines, obtain immediate neurological specialist consultation in patients with suspected acute encephalitis and manage them in a setting where a clinical neurological review can be obtained as soon as possible and definitely within 24 hours of referral.
B
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Empirical therapy
Specific therapy (viruses)
Specific therapy (bacteria)
Specific therapy (mycobacteria)
Specific therapy (rickettsiae and ehrlichiae)
Specific therapy (spirochetes)
Specific therapy (fungi)
Specific therapy (protozoa)
Specific therapy (helminths)
Specific therapy (acute disseminated encephalomyelitis)
Specific circumstances
Follow-up and surveillance
Follow-up
As per ABN/BIA 2012 guidelines:
Do not discharge patients from the hospital without either a definite or suspected diagnosis. Formulate an arrangement for the outpatient follow-up (to include at least one follow-up appointment) and plans for ongoing therapy and rehabilitation at a discharge meeting.
D
Ensure that all patients have access to assessment for rehabilitation, irrespective of age.
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