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History

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  1. From the History of Fire
  2. From the History of Fire Protection in Russia
  3. History
  4. HISTORY
  5. History of International Anatomical Terminology / История Международной анатомической терминологии
  6. History of International Anatomical Terminology / История Международной анатомической терминологии
  7. History of International Anatomical Terminology / История Международной анатомической терминологии 205
  8. History of International Anatomical Terminology / История Международной анатомической терминологии 207
  9. HISTORY OF PSYCHOLOGY

The clinical presentation and course can be markedly variable. The acuity and severity of the presentation correlate with the prognosis. A history of mosquito or tick bites or exposure to mouse/rat droppings should be sought. Recognizing certain mammalian animal bite(s) associated with rabies or exposure to a bat in an enclosed space for which antirabies treatment was not obtained is very important.

The viral prodrome is typically several days and consists of fever, headache, nausea and vomiting, lethargy, and myalgias. The specific prodrome in encephalitis caused by varicella-zoster virus (VZV), Epstein-Barr virus (EBV), cytomegalovirus (CMV), measles virus, or mumps virus includes rash, lymphadenopathy, hepatosplenomegaly, and parotid enlargement. Dysuria and pyuria are reported with St Louis encephalitis. Extreme lethargy has been noted with West Nile encephalitis (WNE).

The classic presentation is encephalopathy with diffuse or focal neurologic symptoms, including the following:

  • Behavioral and personality changes, with decreased level of consciousness
  • Neck pain, stiffness
  • Photophobia
  • Lethargy
  • Generalized or focal seizures (60% of children with CE)
  • Acute confusion or amnestic states
  • Flaccid paralysis (10% of patients with WNE)

Of note, severe headache is not always found. Less common is the complaint of paraspinal backache.

Symptoms of herpes simplex virus (HSV) infection in neonates (aged 1-45 d) may include localized skin, eye, or mouth lesions in the early phase of illness with encephalitis. Diminished alertness, irritability, seizures, and poor feeding develop later in the course of illness, and disseminated disease and shock are late findings.

Herpes simplex encephalitis (HSE) in older children and adults is not typically associated with active herpetic eruptions and is characterized by the acute onset of more severe symptoms of encephalitis early in the course of illness.

Toxoplasma encephalopathy accounts for as many as 40% of HIV-positive patients with neurologic disease who present with a subacute headache, findings of subtle to remarkable encephalopathy, and, often, focal neurological complaints/findings. Rarely, this may be the presenting symptom complex of profound immune suppression due to HIV infection.

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