The clinical hallmarks of acute viral encephalitis include fever, headache, and an altered level of consciousness. Other common clinical findings include behavioral changes, speech disturbances, and focal or diffuse neurologic signs such as seizure or hemiparesis.
Establishing a diagnosis of viral encephalitis may be difficult, so clinicians should inquire about certain epidemiologic features:
- Season of the year
- Prevalent diseases within the community
- History of travel
- Recreational activities
- Occupational exposures
- Animal contacts (insects or animal bites)
The use of neurodiagnostic tests, including electroencephalogram
(EEG), computed tomographic scan, and magnetic resonance imaging (MRI), can provide useful information in the evaluation of encephalitis. Although only herpes simplex encephalitis has specific treatment, the confirmation of other viral causes can provide helpful prognostic information and minimize unnecessary and ineffective therapies. Evaluation and management of acute viral encephalitis can be complex, and practitioners should seek consultation with an infectious diseases specialist for assistance.
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