Bassetti C, Sturzenegger M
Neurologische Universitätsklinik und Poliklinik, Inselspital, Bern.
Ther Umsch. 1999 Nov;56(11):647-52. doi: 10.1024/0040-5930.56.11.647.
Viral encephalitis presents with fever, headache, focal and generalized neurologic symptoms and signs, seizures, and CSF pleocytosis. Herpes simplex Virus (HSV) 1 and arboviruses (flaviruses) are the most common causes of encephalitis in Switzerland. The initial work-up in a suspected encephalitis includes CSF analysis, EEG, and brain CT or MRI. The identification of the responsible agent usually occurs with polymerase chain reaction or serology. The differential diagnosis to other infectious and non-infectious acute CNS-disorders may initially be arduous. A specific treatment is possible only in encephalitis caused by viruses of the herpes group. Active immunization should be considered in subjects at high risk for tick-borne encephalitis. With early treatment the prognosis may be satisfactory also in HSV encephalitis.
病毒性脑炎表现为发热、头痛、局灶性和全身性神经症状及体征、癫痫发作和脑脊液细胞增多。单纯疱疹病毒1型（HSV-1）和虫媒病毒（黄病毒）是瑞士脑炎最常见的病因。疑似脑炎的初步检查包括脑脊液分析、脑电图以及脑部CT或MRI。通常通过聚合酶链反应或血清学来鉴定病原体。与其他感染性和非感染性急性中枢神经系统疾病的鉴别诊断起初可能很困难。仅对由疱疹病毒组病毒引起的脑炎可进行特异性治疗。对于蜱传脑炎高危人群应考虑主动免疫。早期治疗的话，HSV脑炎的预后也可能令人满意。
