Viral encephalitis physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Priyamvada Singh, MBBS [2]; Anthony Gallo, B.S. [3]

Overview[edit | edit source]

Encephalitis is an acute inflammation of the brain, commonly caused by a viral infection. It may present as focal or diffuse neurological manifestations. The signs may include altered mental status, change in personality, meningismus, ataxia, seizures, and cranial nerve involvement. Stiff neck, due to the irritation of the meninges covering the brain, indicates that the patient has either meningitis or meningeoncephalitis.

Physical Examination[edit | edit source]

Appearance[edit | edit source]

• Altered sensorium
• Personality changes

Skin[edit | edit source]

• Herpetic skin lesions

Head[edit | edit source]

• Bulging fontanelles

Eyes[edit | edit source]

• Jaundice in Herpes simplex encephalitis
• Keratoconjunctivitis

Throat[edit | edit source]

• Herpetic lesions in tongue and buccal mucosa (mouth ulcers)

Abdomen[edit | edit source]

• Hepatomegaly

Neurologic[edit | edit source]

Focal neurological signs are found commonly in patients with Herpes simplex encephalitis. Common findings in encephalitis are:

• Cranial nerve palsy
• Autonomic dysfunction
• Hemiparesis
• Meningismus
• Dystonia
• Ataxia
• Abnormal reflexes

References[edit | edit source]

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