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Questions posted in the
Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.
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Subject: Re: viral encephalitis : A friend is coming to Cleveland for evaluation. She has had mild-to-moderate headaches for about one year. She has an abnormal M.R.I. She has had a brain biopsy which was abnormal, but not diagnostic. The specimen was sent to a neuropathologist at the Mayo Clinic. He recommended a repeat brain biopsy. Viral encephalitis may be a possibility. Do you have a neurologist at the Cleveland Clinic that you would especially recommend for her to see? Are there any studies that you would suggest that she obtain here prior to coming for an appointment? = Hello, Dr. Milton, There are several neurologists at our department that are specialized in this field, represented by Drs. P. Sweeney, R. Lederman, K. Levin and R. Shields. As far as the lab work-up for viral encephalitis, I would get arbovirus, herpes (esp. HSV1), HIV, CMV, and VZV. Depending on the clinical presentation, LP may be necessary to study CSF virology. In addition, fungal and parasitic etiologies should be considered in the setting of chronic headache and abnormal MRI. It is important to keep in mind that several more clinical entities are on the list of differential, including aseptic meningitis, subdural hematoma, and vascular etiology. Based on her neurological examination, we will select more tests for her when she is here for evaluation. Please call toll free at (800)223-2273 ext. 45559 if she has not got her admission. This information is provided for general medical educational purpose only. Please consult your physician for the diagnostic and treatment options of your specific condition. |
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