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Herpes simplex virus infection presenting as stroke-like symptoms with atypical MRI findings
Camilla N Clark, Nader Khandanpour, Anthony C Pereria
A previously independent 63-year-old women with obesity, obstructive sleep apnoea, type 2 diabetes, and hypercholesterolaemia presented to our stroke team on July 25, 2017, with sudden-onset receptive and expressive dysphasia and right-sided neglect. Her symptoms were managed with antiplatelets. 5 days earlier, she had fallen and sustained an undisplaced fracture of the right humerus. Subsequently, she had intermittent confusion (eg, she was unable to recall her daughter’s name and had placed her mobile phone in boiling water). Low attenuation mimicking acute infarction was visible, on an unenhanced CT brain scan, in the left insular cortex. She progressed rapidly, developing pneumonia, heart failure, and seizures.
HSV presenting as stroke-like symptoms with atypical MRI findings

Clinical Epidemiology, Risk Factors, and Outcomes of Encephalitis in Older Adults
Michael A Hansen, MD, Mohammed S Samannodi, MD, Rodrigo Lopez Castelblanco, MD, Rodrigo Hasbun, MD, MPH
Background: Encephalitis is associated with significant morbidity and mortality with unknown etiologies in the majority of patients. Large prognostic studies evaluating elderly patients are currently lacking.
Methods: Retrospective cohort of encephalitis cases in 19 hospitals from New Orleans, Louisiana and Houston, Texas between the years 2000 and 2017.
Conclusion: Encephalitis remains with adverse clinical outcomes and unknown etiologies in the majority of patients in the molecular diagnostic era. Independent prognostic factors include age >65 years, fever, GCS <13 and seizures.

A Systematic Review of the Natural Virome of Anopheles Mosquitoes
Ferdinand Nanfack Minkeu and Kenneth D. Vernick
Anopheles mosquitoes are vectors of human malaria, but they also harbor viruses, collectively termed the virome. The Anopheles virome is relatively poorly studied, and the number and function of viruses are unknown. Only the o’nyong-nyong arbovirus (ONNV) is known to be consistently transmitted to vertebrates by Anopheles mosquitoes.
In addition to ONNV, other viruses with potential to cause febrile disease if transmitted to humans or other vertebrates have been isolated from Anopheles, including Nyando virus [18,19], Batai virus [20], Japanese encephalitis virus [21], Myxoma virus [22], and West Nile virus [23]. 

Subacute Sclerosing Panencephalitis: The Devastating Measles Complication That Might Be More Common Than Previously Estimated.
Wendorf KA, Winter K, Zipprich J, Schechter R, Hacker JK, Preas C, Cherry JD, Glaser C, Harriman K.
BACKGROUND: Subacute sclerosing panencephalitis (SSPE) is a fatal complication of measles. We reviewed California cases from 1998-2015 to understand risk factors for SPPE and estimate incidence.

Systematic review of rehabilitation intervention outcomes of adult and paediatric patients with infectious encephalitis
Shanice Christie, Vincy Chan, Tatyana Mollayeva, and Angela Colantonio
Objective Although a range of rehabilitation interventions have been applied to restore function after infectious encephalitis, there is a lack of literature summarising the benefits of these interventions. This systematic review aims to synthesise current scientific knowledge on outcome measures following rehabilitative interventions among children and adults with infectious encephalitis, with a specific focus on the influence of the age, sex, baseline status and intervention type.
Search strategy Five scholarly databases (MEDLINE, Embase, PsycINFO, CINAHL and Cochrane Central Register of Controlled Trials), three sources of grey literature (Google, Google Scholar and Grey Matters) and reference lists of included publications were systematically searched. Literature published before 15 December 2017 and focused on patients with infectious encephalitis in any rehabilitation setting were included.

Incidence, Risk Factors and Outcomes Among Children With Acute Flaccid Myelitis:

A Population-based Cohort Study in a California Health Network Between 2011 and 2016
Kane MS, Sonne C, Zhu S, Malhotra A, Van Haren K, Messacar K, Glaser CA
BACKGROUND: Acute flaccid myelitis (AFM) is defined as an acute onset of limb weakness with longitudinal spinal gray matter lesions. Reporting bias and misdiagnosis confound epidemiologic studies of AFM. We mitigated these confounders by using a large data set to assess AFM incidence, risk factors and outcomes in a fixed population.
Incidence, Risk Factors and Outcomes Among Children with AFM

Experts by Experience – A compilation of patients’ stories
Compiled by Brian Loew, Co-founder and CEO of Inspire. Includes a story from Encephalitis411 Board President Becky Dennis.
A special report by Inspire, developed in cooperation with the Stanford University School of Medicine In early 2012, Inspire partnered with the Stanford University School of Medicine to provide a monthly column for the Scope medical blog. This report, Experts by Experience, is made up of a year’s worth of columns from patients of all types and backgrounds. An underpinning of all the columns is the desire by patients for their doctors to truly hear them, and consider them a partner in the care process. Many patients want to share their stories, to help themselves and others. As Laura Haywood-Cory, a woman with a rare heart disorder, said, “As patients, we need to not expect perfection from our doctors until we achieve it in ourselves. And doctors need to give themselves permission to not know everything and to not feel threatened by empowered, educated patients.” 

Herpes Simplex Virus-1 Encephalitis in Adults: Pathophysiology, Diagnosis, and Management 
Michael J. Bradshaw and Arun Venkatesan
Herpetic infections have plagued humanity for thousands of years, but only recently have advances in antiviral medications and supportive treatments equipped physicians to combat the most severe manifestations of disease. Prompt recognition and treatment can be life-saving in the care of patients with herpes simplex-1 virus encephalitis, the most commonly identified cause of sporadic encephalitis worldwide. Clinicians should be able to recognize the clinical signs and symptoms of the infection and familiarize themselves with a rational diagnostic approach and therapeutic modalities, as early recognition and treatment are key to improving outcomes. 

Case Definitions, Diagnostic Algorithms, and Priorities in Encephalitis
A. Venkatesan, A. R. Tunkel, K. C. Bloch, A. S. Lauring, J. Sejvar, A. Bitnun, J-P. Stahl, A. Mailles, M. Drebot, C. E. Rupprecht, J. Yoder, J. R. Cope, M. R. Wilson, R. J. Whitley, J. Sullivan, J. Granerod, C. Jones, K. Eastwood, K. N. Ward, D. N. Durrheim, M. V. Solbrig, L. Guo-Dong, and C. A. Glaser; on behalf of the International Encephalitis Consortium
Background. Encephalitis continues to result in substantial morbidity and mortality worldwide. Advances in diagnosis and management have been limited, in part, by a lack of consensus on case definitions, standardized diagnostic approaches, and priorities for research.
Methods. In March 2012, the International Encephalitis Consortium, a committee begun in 2010 with members worldwide, held a meeting in Atlanta to discuss recent advances in encephalitis and to set priorities for future study.
Results. We present a consensus document that proposes a standardized case definition and diagnostic guidelines for evaluation of adults and children with suspected encephalitis. In addition, areas of research priority, including host genetics and selected emerging infections, are discussed.
Conclusions. We anticipate that this document, representing a synthesis of our discussions and supported by literature, will serve as a practical aid to clinicians evaluating patients with suspected encephalitis and will identify key areas and approaches to advance our knowledge of encephalitis.
Case Definitions, Diagnostic Algorithms, and Priorities in Encephalitis

Burden of encephalitis-associated hospitalizations in the United States 1998-2010
Objective: To estimate the burden of encephalitis-associated hospitalizations in the United States for 1998–2010.
Methods: Using the Nationwide Inpatient Sample, a nationally representative database of hospitalizations, estimated numbers and rates of encephalitis-associated hospitalizations for 1998–2010 were calculated. Etiology and outcome of encephalitis-associated hospitalizations were
examined, as well as accompanying diagnoses listed along with encephalitis on the discharge records. Total hospital charges (in 2010 US dollars) were assessed.
Burden of encephalitis associated hospitalizations

The Management of Encephalitis: Clinical Practice Guidelines by the Infectious Diseases Society of America
Allan R. Tunkel, Carol A. Glaser, Karen C. Bloch, James J. Sejvar, Christina M. Marra, Karen L. Roos, Barry J. Hartman, Sheldon L. Kaplan, W. Michael Scheld, and Richard J. Whitley
Guidelines for the diagnosis and treatment of patients with encephalitis were prepared by an Expert Panel of the Infectious Diseases Society of America. The guidelines are intended for use by health care providers who care for patients with encephalitis. The guideline includes data on the epidemiology, clinical features, diagnosis, and treatment of many viral, bacterial, fungal, protozoal, and helminthic etiologies of encephalitis and provides information on when specific etiologic agents should be considered in individual patients with encephalitis.        . . . . .

I’m Not the Me I Remember
Contributions from Encephalitis411 founding board members Becky Dennis and Bob Morris
A special report co-authored by Inspire and Encephalitis Global, Inc., documenting “life after encephalitis.” Inspire provides a number of online communities for people affected by rare diseases, where patients and caregivers reach out to each other. These connections are particularly profound in groups devoted to those affected by rare diseases.