Clinical spectrum and outcomes of patients with encephalitis requiring intensive care

Abstract

Indicators of outcome in adult patients with severe encephalitis reflect both the severity of illness and systemic complications. Our data suggest that patients with acute encephalitis may benefit from early ICU admission.

A study on viral CNS inflammation beyond herpes encephalitis

“…Outcome in both entities has been previously discussed to be similar (Raschilas et al 2002;Sonneville et al 2015) and is often characterized by neuropsychological deficits (Grahn and Studahl 2015) which is in accordance with our findings. In contrast with previously reported fatality rates of 7-35 % in HSVE and of 20 % in VZVE (Grahn and Studahl 2015;Granerod et al 2010;Sili et al 2014;Singh et al 2016), the outcome in our study was more favorable as none of our patients died.…”

Early-onset status epilepticus in patients with acute encephalitis

“…Poor neurologic outcome was defined by a modified Rankin score of 4 to 6. [4] Patients discharged within 90 days with a disability had their charts reviewed and were classified according to the latest available data. Patients discharged from hospital within 90 days following ICU admission without disability were considered to have a good outcome.…”

“…[1] Mortality rates among adult patients range between 7% and 18% and neurological sequelae are reported in more than 50% of survivors. [2–4] Patients with acute encephalitis may require intensive care unit [ICU] admission for various reasons, including impaired consciousness, respiratory failure, or complicated seizures. [2,4] …”

“…[3,4] They are influenced by several factors, including the patient's history, central nervous system (CNS) inflammation, and cortical lesions. [5,6] The risk of seizures may also differ depending on the cause of encephalitis, being reported in more than 40% of patients with encephalitis of viral origin.…”

“…Indeed, more recent studies showed no significant association between seizures or SE and 3-month neurologic outcomes. [3,4] Recently, acute encephalitis was found to be associated with the onset of super-refractory SE, [11] a condition carrying a very poor prognosis. [12] In a previous study of patients undergoing continuous electroencephalographic monitoring, electrographic seizures occurred in 33% of cases and were independently associated with poorer outcomes.…”