Analysis Of Clinical Features And Prognosis In160Patients With Viral Encephalitis

ObjectiveTo study the clinical and imaging features associated with short termprognosis in patients with viral encephalitis especially these of limbicencephalitis and to discuss the etiology, diagnosis and treatment. of limbicencephalitis.MethodsClinical data of160patients diagnosed with viral encephalitis in theFirst Affiliated Hospital of Chongqing Medical University from January2006to May2010were analyzed retrospectively. All patients were dividedinto favorable and poor prognosis groups according to the GlasgowOutcome Scale. The relationship between several factors and prognosis wasinvestigated by multifactor Logistic regressive analysis Another clinicaldata of20patients diagnosed with limbic encephalitis in the First AffiliatedHospital of Chongqing Medical University from September2010to March2012were collected prospectively. The clinical features, CSF test results, MRI and EEG were analysed. In additon, all patients were underwentserum and/or CSF anti NMDAR antibody detection. Compared with viralencephalitis, the difference of clinical manifestations of LE wasmanifested.Results1. Univariate analysis showed the difference of head MRIabnormalities, EEG abnormalities, conscious disturbance psychologicalproblem, epilepsy, headache, motor defects between favorable prognosisgroup and poor prognosis group in VE was statistical significant (P<0.05).However, only head MRI abnormalities and conscious disturbance wereproved to be closely related to prognosis by multifactor Logistic regressiveanalysis. Furthermore, patients with multiple lesions in head MRI had aworse prognosis compared to those with single lesion (P=0.03OR=13.095%CI=2.4070.46).2. The main characterestics of patients with limbic encephalitis weremental symptoms, autonomic nervous system dysfunction and epilepsy,. Insevere cases, central ventilatory dysfunction could happen. MRI showedmost patients had abnormal signals on limbic system. The resultes of EEGand CSF showed little specificity. One patient was tested positively inanti NMDAR antibody detection. All cases had a better response tohormone and immune therapy, and Barthel Index scores were significantlyimproved after treatment. Univariate analysis showed that only personality changes was different between favorable prognosis group and poorprognosis group in the patients with LE.3. Conscious disturbance seizure and psychiatric symptoms(including hallucinations, personality changes, irritability) in patients withLE were more common than in patients with VE P <0.05.Conclusions1.The conscious disorder and head MRI abnormalities are the two mostimportant factors related to short time prognosis in patients with viralencephalitis2. The causes of limbic encephalitis are numerous, and antibody testsare helpful to the clinical diagnosis. Patients with anti NMDARantibodies associated encephalitis will have a better prognosis throughearly diagnosis and treatment.3. Seizures, disturbance of consciousness, and psychiatric symptomsare more common in patients with LE.