Acute viral encephalitis clinical features and outcome: Experience from a tertiary center of North India

Abstract

Background: Acute viral encephalitis (AVE) is an unconscious state that either accompanies or follows a short febrile viral illness and is characterized by a diffuse and nonspecific brain insult manifested by the combination of coma, seizures, and decerebration and frequently results in delayed neurological deficit. Aim and Objective: To evaluate the clinical features and the outcomes of patients presenting with AVE. Materials and Methods: The patients presenting with AVE with serologically confirmed viral parameters were consecutively recruited from the department of medicine/neurology from a tertiary care center of Lucknow, Uttar Pradesh, India. These patients were then subjected to detailed clinical examination, laboratory examination, and radiological assessment. The modified Rankin Scale (mRS) was calculated at the time of discharge and after 1 month of follow-up. Results: One hundred and eight patients were diagnosed with AVE over a period of 2 years. The mean age of the patients of AVE was 28.97 ± 16.7 years. The most common complaints were fever (100%), headache (94.4%), and altered mental state (92.5%). Out of the 108 patients, Japanese encephalitis (JE) was the most common etiology followed by herpes simplex virus (HSV) encephalitis. Of the total number of patients, 27 died, 9 were diagnosed with JE, 4 with hematopoietic stem cell (HSC) encephalitis, 5 with miscellaneous group, and 11 with the nonspecific group of viral encephalitis (NSAVE). The mRS at discharge was 3 in 35 patients with AVE. After 1 month, mRS was 3 in 22 patients with AVE. Conclusion: In this study, JE meningitis was the leading cause of AVE followed by NSAVE and HSV encephalitis. The outcome in cases with AVE can be fatal or more disabling than other etiologies and prompt diagnosis and supportive care remain the backbone of treatment.