| Objective: In order to study the clinical manifestations, CSF, EEG as well as imaging traits, improve diagnostic skill.Methods: Retrospective analysis was conducted in 32 cases of patients with viral encephalitis during the period of 2006~2007.Results: (1)Most the patients in this group are young, including 16 males and 16 females, the average age was 32.44±14.89. (2) 62.50% had prodromal infection, The mode of onset were mostly acute 84.38%. (3) The onset symptoms were fever (65.62%), headache (46.88%), psychiatric symptom(21.88%)and seizures (18.75%), clinical symptoms fever (87.5%), seizures(75.0%), psychiatric symptom (62.50%) and concious disturbance (62.50%). (4)CSF: Normal CSF 37.5%. 62.50% patients had increased leucocyte, 75% 10~200×106?L, 46.88% patients had increased protein, mean 0.74±0.24g?L. In patients with abnormal CSF, following 14 days treatment the CSF were re-examined in 6 patients , no improvement was found, following 4 weeks treatment the CSF were re-examined in 3 patients, two of them were recovered whereas no improvement was found in one of them. (5)Imaging: Only 3.13% patients were abnormal in CT examination. 68.75% of patients were found abnormal in cerebral MRI examination. Pathological changes located temporal lobe (68.19%), hippocamp(59.09%) ,lobus insularis (59.09%), frontal lobe( 54.55%).Within onset 7 days the MRI examination were performed first time in 9 patients, 6 patients had normal MRI, whereas they appeared abnormal one week later. During the period of onset 7 days to 14 days , the MRI examination were performed in 23 patients first time,15 cases had abnormal change MRI. After onset 4 weeks despite clinical improvement, the MRI examination were performed again in 5 patients , 4 in 5 patients have not found any MRI changes after onset of 4 weeks although their clinical symptom improved.About onset 2 months 1 patient had a fully recovery ,however MRI showed deterioration.(6)About 84.38% of patients have abnormal EEG, at onset 4 weeks when they had a good recovery ,EEG examination were performed again in 13 patients,all had improvement. (7)Treatment and prognosis:32 cases had given anti-microbial, anti-viral allopathi and Supportive treatment, 56.25% were cured fundamentally, 40.63% had sequelae, 3.12% died.Conclusion①Most the VE patients are young,there are no difference in sexuality. The mode of onset of the VE were mostly acute.②In general, viral encephalitis is typified with fever, emotional disturbance, conscious disturbance and possible seizures.③Counting of CSF cells and level of proteins with slight to moderate increasing can be expected. CSF may not recover although clinical features have improved greatly,CSF changes may be not coincident with patient's clinical condition.④MRI usually shows one or both frontal or temporal lobes abnormal. However, the MRI may occasionally be normal for the first few days after the onset of symptoms, dispite clinical improvement MRI have not a good recovery. MRI have important diagnotic value, also may be not coincident with patient's condition.⑤EEG abnormal rate 84.38%, EEG is very sensitive, have higher diagnotic value, it's severity has direct correlation with patient's condition.⑥The clinical appearance of VE is not typical, to diagnose the disease needs aggregatirely analyze the clinical symptom and auxiliary examination. |
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