Magazine article Clinical Psychiatry News

Consider Acute Viral Encephalitis with Unexplained Psychosis

Magazine article Clinical Psychiatry News

Consider Acute Viral Encephalitis with Unexplained Psychosis

Article excerpt

Familiarity with the clinical signs and epidemiology of encephalitis is critical in avoiding misdiagnosis of this elusive condition which often presents as a psychiatric disorder, said Dr. Stanley N. Caroff and his associates at the University of Pennsylvania in Philadelphia.

The researchers reviewed 108 published cases of psychiatric disorders that had suspected or confirmed viral infections of the central nervous system. The psychiatric symptoms, which initially presented as encephalitis, were clustered into four major syndromes: acute psychosis (35%), catatonia (33%), depression with psychotic features (16%), and mania (11%).

These presentations were not mutually exclusive, the researchers said; a patient could, in fact, manifest symptoms of several syndromes (Psychiatric Annals 31[3]:193-202, 2001).

Because these psychiatric symptoms are nonspecific, they are often difficult to distinguish from classical psychiatric disorders--especially in the absence of obvious neurologic symptoms. The investigators recommended taking careful note of symptoms such as headaches, fever, disorientation, or seizures.

The presence of nausea, vomiting, extrapyramidal signs and oculomotor dysfunction also provide important clues, they said. …

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