Acute encephalitis in immunocompetent adults

被引：102

作者：

Venkatesan, Arun ^{[1
]}

Michael, Benedict D. ^{[4
,5
,6
]}

Probasco, John C. ^{[1
]}

Geocadin, Romergryko G. ^{[1
,2
,3
]}

Solomon, Tom ^{[5
,6
]}

机构：

[1] Johns Hopkins Univ, Sch Med, Dept Neurol, Johns Hopkins Encephalitis Ctr, Baltimore, MD 21205 USA

[2] Johns Hopkins Univ, Sch Med, Dept Neurosurg, Baltimore, MD 21205 USA

[3] Johns Hopkins Univ, Sch Med, Dept Anaesthesia Crit Care, Baltimore, MD USA

[4] Harvard Med Sch, Ctr Immune & Inflammatory Dis, Massachusetts Gen Hosp, Boston, MA USA

[5] Univ Liverpool, Natl Inst Hlth Res Hlth Protect Res Unit Emerging, Inst Infect & Global Hlth, Liverpool, Merseyside, England

[6] Walton Ctr NHS Fdn Trust, Dept Neurol, Liverpool, Merseyside, England

来源：

LANCET | 2019年 / 393卷 / 10172期

基金：

美国国家卫生研究院; 欧盟地平线“2020”; 英国惠康基金;

关键词：

NMDA-RECEPTOR ENCEPHALITIS; HERPES-SIMPLEX ENCEPHALITIS; ACUTE DISSEMINATED ENCEPHALOMYELITIS; AUTOIMMUNE ENCEPHALITIS; CLINICAL-PRACTICE; JAPANESE ENCEPHALITIS; PROGNOSTIC-FACTORS; DIAGNOSIS; MANAGEMENT; THERAPY;

D O I：

10.1016/S0140-6736(18)32526-1

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Encephalitis is a condition of inflammation of the brain parenchyma, occurs as a result of infectious or autoimmune causes, and can lead to encephalopathy, seizures, focal neurological deficits, neurological disability, and death. Viral causes account for the largest proportion, but in the last decade there has been growing recognition of anti-neuronal antibody syndromes. This Seminar focuses on the diagnosis and management of acute encephalitis in adults. Although viral and autoimmune causes are highlighted because of their prominent roles in encephalitis, other infectious pathogens are also considered. The role of cerebrospinal fluid studies, MRI, and novel diagnostic modalities (eg, next-generation sequencing) are discussed. Management approaches, including treatment of acute neurological complications and the use of immune suppressive and modulatory drugs for cases of suspected or confirmed autoimmune cause, are covered. Additionally, we discuss the remaining challenges in the diagnosis, management, and prognosis of encephalitis.

引用

页码：702 / 716

页数：15

共 125 条

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