Acute confusion and seizures in a 63-year-old woman

Benninger, Felix; Shemesh, Tamar; Steiner, Israel

doi:10.1016/j.jocn.2012.02.018

Cited by 1 publication

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“…If the clinical presentation is highly suspicious for encephalitis, a spinal fluid analysis returning with only borderline elevated cells should be repeated as, especially in HSE, a normal CSF can be seen in the first hours of infection. This can cause a treatment delay, worsening the prognosis of the encephalitis or leading to an alternative wrong diagnosis (de Toledo et al, 2001;Benninger et al, 2013;Desena et al, 2014;Saraya et al, 2016). In HSE at least 10% have normal cell counts within a week of onset of illness, usually, but not always, increasing later (Koskiniemi et al, 1984).…”

Section: Csf Analysis: Cells and Chemistrymentioning

confidence: 99%

CSF in acute and chronic infectious diseases

Benninger

Steiner

2018

Handbook of Clinical Neurology

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Infections of the nervous system are an important and challenging aspect of clinical neurology. Immediate correct diagnosis enables to introduce effective therapy, in conditions that without diagnosis may leave the patient with severe neurological incapacitation and sometimes even death. The cerebrospinal fluid (CSF) is a mirror that reflects nervous system pathology and can promote early diagnosis and therapy. The present chapter focuses on the CSF findings in neuro-infections, mainly viral and bacterial. Opening pressure, protein and glucose levels, presence of cells and type of the cellular reaction should be monitored. Other tests can also shed light on the causative agent: serology, culture, staining, molecular techniques such as polymerase chain reaction. Specific examination such as panbacterial and panfungal examinations should be examined when relevant. Our chapter is a guide-text that combines clinical presentation and course with CSF findings as a usuaful tool in diagnosis of neuroinfections. ACUTE INFECTIOUS DISEASES OF THE NERVOUS SYSTEMAcute infections of the nervous system are as diverse in their clinical consequences for the patient as the variety of infectious agents causing them: from mild headaches to long-term morbidity and a threat to life. Therefore, the earliest possible diagnosis is absolutely essential. Central here stands the examination of the CSF. The correct diagnosis is often dependent on this rather simple procedure to allow diagnosis and focused antimicrobial and adjunctive therapy. This chapter deals with acute infectious diseases of the nervous system and the importance of the lumbar puncture (LP) in the diagnostic process.

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