Which physical findings suggest encephalitis?

Updated: Aug 07, 2018
  • Author: David S Howes, MD; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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Answer

Look for supporting evidence of viral infection. The signs of encephalitis may be diffuse or focal. At the extremes, 80% of patients with HSE present with focal findings. Typical findings include the following:

  • Altered mental status

  • Personality changes are very common

  • Focal findings, such as hemiparesis, focal seizures, and autonomic dysfunction

  • Movement disorders (St Louis encephalitis, eastern equine encephalitis [EEE], western equine encephalitis [WEE])

  • Ataxia

  • Cranial nerve defects

  • Dysphagia, particularly in rabies

  • Meningismus (less common and less pronounced than in meningitis)

  • Unilateral sensorimotor dysfunction (postinfectious encephalomyelitis [PIE])


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