Division of Neuroimmunology and Neuroinfectious Diseases, Department of Neurology, Johns Hopkins Encephalitis Center, Johns Hopkins University School of Medicine, 600 N Wolfe Street, Baltimore, MD 21287, USA.
Division of Neuroimmunology and Neuroinfectious Diseases, Department of Neurology, Johns Hopkins Encephalitis Center, Johns Hopkins University School of Medicine, 600 N Wolfe Street, Baltimore, MD 21287, USA.
Neurol Clin. 2018 Nov;36(4):705-724. doi: 10.1016/j.ncl.2018.07.001. Epub 2018 Sep 20.
Viruses are a frequent cause of encephalitis. Common or important viruses causing encephalitis include herpesviruses, arboviruses, enteroviruses, parechoviruses, mumps, measles, rabies, Ebola, lymphocytic choriomeningitis virus, and henipaviruses. Other viruses may cause an encephalopathy. Host factors and clinical features of infection are important to consider in identifying the cause for encephalitis. Cerebrospinal fluid evaluation, serologic/polymerase chain reaction studies, and neuroimaging are cornerstones of diagnostic evaluation in encephalitis. Treatable forms of encephalitis are important to consider in all cases. Central nervous system inflammation may also occur because of postinfectious autoimmunity, such as acute disseminated encephalomyelitis or antibody-mediated encephalitis after herpes simplex virus encephalitis.
病毒是脑炎的常见病因。引起脑炎的常见或重要病毒包括疱疹病毒、虫媒病毒、肠道病毒、细小病毒、腮腺炎病毒、麻疹病毒、狂犬病病毒、埃博拉病毒、淋巴细胞性脉络丛脑膜炎病毒和亨尼帕病毒。其他病毒也可能引起脑病。在确定脑炎的病因时，宿主因素和感染的临床特征是需要考虑的重要因素。脑脊液评估、血清学/聚合酶链反应研究和神经影像学是脑炎诊断评估的基石。在所有情况下，都需要考虑治疗性脑炎。中枢神经系统炎症也可能是由于感染后自身免疫引起的，如急性播散性脑脊髓炎或单纯疱疹病毒性脑炎后的抗体介导性脑炎。
