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Re: encephalitis

Posted By CCF NSG MD /gsh on July 08, 1998 at 09:11:46:

In Reply to: encephalitis posted by anne on June 27, 1998 at 10:09:23:

My daughter aged six was admitted to hospital after a first time seizure with a high temperature after an illness of approx two weeks duration(Given antibiotic).
While in hospital she suffered three futher seizures within an eight hour period.
She was given diazepam. An initial EEG confirmed the suggested diagnosis of encephalitis and she was treated with intravenous acyclovir.
Lumbar punctures and blood tests failed to identify the cause of the encephalitis and she continued to have seizures which were treated with a loading dose of Phenytoin.  
She then began to have repeated absences and was confused and did not know members of her own family.  
Her short term memory over the period in hospital was very poor with constant repetition of questions.
On her return home she has made good progress with little after effects apart from weight gain and severe headaches which did not respond to pizotifen, the prescribed drug.
She has since had two seizures one of which was status and has been on the drug ethosuximide which seems to be controlling the headaches.
After the seizures she came round normally with no confusion and no problems of recogniion.  
Nine months later her consultant asked for a second opinion on her EEGs(her EEG suggests absence seizures but she presents with full seizures)and the result of this request
was that the initial diagnosis may have been wrong and that she did not have encephalitis after all
and that whwn she was originally admitted that she may have been suffering from epilepsy.  Is this possible considering
her long term level of confusion and her two week temperature(39+)after the onset of seizures.


Dear Anne,
Febrile seizures are not uncommon in children and are usually an isolated incident
without further recurrence of seizures.  A small number of these children will
have recurrent seizures and are given the diagnosis of epilepsy.  Epilepsy,
or recurrent seizure activity, is most often treated medically.  Seizure activity
that is refractory to medical therapies can sometimes be treated surgically.
It sounds like your daughter may have epilepsy, or recurrent seizure activity.
The question is why does she have epilepsy.  Many diseases can cause epilepsy such
as tumors, infection and developmental abnormalities to randomly name a few.
Your daughter may have had encephalitis, and this may have been the cause for
her seizures.  The results of the EEG's, spinal taps and head images would
be useful in diagnosing the cause of the epilepsy.
Speak to your daughter's physician for some clear answers as to the type
of seizures she is having and what may be the cause.  If you cannot find
clear answers, then seek another opinion.
You may opt for a consultation from an Epilepsy Neurologist at the Cleveland
Clinic by calling 800-223-2273.  Ask the operator for the Neurology desk.
Good luck.

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