Viral encephalitis physical examination

Viral encephalitis Microchapters

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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

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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

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### Appearance

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* Altered sensorium
* Personality changes

### Skin

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* Herpetic skin lesions

### Head

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* Bulging fontanelles

### Eyes

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* Jaundice in Herpes simplex encephalitis
* Keratoconjunctivitis

### Throat

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

### Abdomen

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* Hepatomegaly

### Neurologic

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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

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