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

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

Appearance

• Altered sensorium
• Personality changes

Skin

• Herpetic skin lesions

Head

• Bulging fontanelles

Eyes

• Jaundice in Herpes simplex encephalitis
• Keratoconjunctivitis

Throat

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

Abdomen

• Hepatomegaly

Neurologic

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