Treatment

There is no specific therapy for most forms of viral encephalitis in previously healthy individuals. With the success of early therapy with intravenous aciclovir in HSE, it is imperative to identify the organism as quickly as possible. The most sensitive and rapid way of detecting HSV and other viruses is by PCR.6,715 The application of PCR in HSE has a sensitivity of 95% and a specificity of 94%.16 Brain biopsy no longer has a place in the diagnosis of viral encephalitis, except to determine if a lesion demonstrated by scan is an abscess, granuloma, or tumour. It is safer to begin treatment with aciclovir in essentially all patients with unexplained encephalitis.17 If another aetiology is subsequently identified, then aciclovir can be stopped. Effective therapy for most other viral encephalitides has not yet been clearly established and generally the treatment of viral encephalitis is symptomatic and requires maintenance of adequate nutrition, hydration, and oxygenation. Some potentially useful treatments are under clinical evaluation, such as pleconaril for enteroviral meningoencephalitis.9 Seizures are controlled with anticonvulsants and secondary infections are treated as necessary. Intracranial hypertension and cerebral oedema may be a problem but there is no consensus on the correct treatment. Intubation and hyperventilation, glycerol, mannitol, and dexamethasone have all been used, although there are theoretical objections to the last in HSE. The subject has been extensively reviewed.18

Blood Pressure Health

Blood Pressure Health

Your heart pumps blood throughout your body using a network of tubing called arteries and capillaries which return the blood back to your heart via your veins. Blood pressure is the force of the blood pushing against the walls of your arteries as your heart beats.Learn more...

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