Casedefinition
Box1Encephalitiscasedefinitionfromtheinternationalencephalitisconsortium14
MajorCriterion(required):
Patientspresentingtomedicalattentionwithalteredmentalstatus–definedasdecreasedoralteredlevelofconsciousness,orlethargyorpersonalitychange–lasting≥24h.
MinorCriteria(2forpossibleencephalitis;≥3forprobableorconfirmedencephalitis):
1Documentedfever≥38°C(.4°F)withinthe72hbeforeorafterpresentation.
2Generalisedorpartialseizuresnotfullyattributabletoapreexistingseizuredisorder.
3Newonsetoffocalneurologicfindings.
4CSFWBCcount≥5/mm3.
5Abnormalityofbrainparenchymaonneuroimagingsuggestiveofencephalitisthatiseithernewfrompriorstudiesorappearsacuteinonset.
6Abnormalityonelectroencephalographythatisconsistentwithencephalitisandnotattributabletoanothercause.
ANDExclusionofencephalopathycausedbytrauma,metabolicdisturbance,tumour,alcoholabuse,sepsisandothernoninfectiouscauses.
Box2Selecteddifferentialdiagnosesofsuspectedmeningo-encephalitis
Meningitiswithoutparenchymalinvolvement:bacterial,viral,
other(e.g.TB,cryptococcus).
Cerebralabscessandotherformsofintra-cranialsuppuration.
Infectionassociatedencephalopathy(e.g.septicencephalopathy,acutenectrotisingencephalopathy(ANE)).
Vasculardisease:ischaemic/haemorrhagiccerebro-vascularaccident(CVA),cerebralvasculitides(e.g.systemiclupuserythematosus).
Hypertensiveencephalopathyincludingposteriorreversibleencephalopathysyndrome(PRES).
Neoplastic:primaryCNSormetastatic,haematologicmalignancies.
Toxininducedencephalopathy:alcohol,illicitdrugs,otherdrugs(especiallyneuroleptics,cyclosporin).
Metabolicencephalopathy:hepatic,renal,hypoglycaemia,hyponatraemia,hypocalcaemia,thiaminedeficiency,Wilsondisease.
Neurodegenerative:fronto-temporaldementia,Creutzfeld-Jacobdisease(otherpriondisease),neuroacanthocytosis.
Demyelinatingdisease:multiplesclerosis(MS),neuromyelitis
optica(NMOorDevicdisease).
Endocrine:Hashimoto’sencephalopathy/steroidresponsiveencephalopathyassociatedwithautoimmunethyroiditis(SREAT),Addisoniancrisis.
Psychiatric:psychosis,catatonia.
Seizuredisorder.
Traumaticbraininjury.
Intussusception.
Box3Selectedimmune-mediatedencephalitides
ADEM18,19
Acutedisseminatedencephalomyelitisisaninflammatory,multi-focal,demyelinatingconditionofthecentralnervoussystem.Itpresentswithencephalopathyandmulti-focalneurologicaldeficits.Itismost中科白癜风医院怎么样中科大型白癜风公益援助
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