Internal Medicine

P1: OXT/OZN/JDO P2: PSB

0521779407-E-01 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 21:10

522 Ehlers-Danlos Syndrome Encephalitis

■Life-threatening spontaneous arterial rupture, bowel rupture, or

uterine rupture in type IV

Prognosis

■Normal life expectancy, except type IV (few live past age 40)

Encephalitis........................................

CAROL A. GLASER, MD

history & physical

History

■Definition: inflammation of the brain parenchyma

■Many individuals also with meningeal involvement (“meningoen-

cephalitis”)

■Significant morbidity and mortality

■2 entities:

➣acute/infections – often gray matter

➣postinfections: often white matter involvement, primarily demy-

elinating process

➣overlap in clinical manifestations of infectious vs. postinfectious

Signs & Symptoms

■Altered mental status is hallmark of encephalitis.

■Fever and headache

■Often with lethargy and confusion that may progress to stupor and

coma

■Seizures and focal neurologic findings also seen

➣Bizarre behavior, hallucination, aphasia is characteristic of her-

pes but can be seen with many other agents

Causative Agent

■Most cases presumed viral, though many bacteria and fungi have

been associated

➣Viral agents include but not limited to:

➣Herpesviruses (HSV1, HSV2, VZ*, CMV, EBV*, HHV6)

■Enteroviruses

■Arboviruses (e.g. SLE, WEE, EEE, VEE, West Nile)

■Measles*

■Mumps*

■Respiratory viruses; Influenza A/B*, Parainfluenza*, adenovirus