PROTRACTED FORM OF ENCEPHALITIS WITH GOOD OUTCOME

Objective: To present four patients seen over a five-year period who developed severe protracted encephalitic illnesses but whose outcomes were favourable. Clinical features: Of the four patients, aged 18, 22, 34 and 19, three presented with acute psychosis, and all had a prolonged clinical course requiring intensive care management. One patient had residual generalised seizures and the other three recovered fully. No infective or toxic agent could be identified but viral encephalitis was considered most likely. Outcome: Despite the protracted courses, the outcomes were favourable. This is in contrast to the generally poor outcomes in encephalitis caused by established infective agents such as herpes simplex type 1. Conclusions: When the aetiology and hence the natural history of the encephalitis is unknown, long-term intensive support is appropriate.