TABLE 2273 Viral Pathogens Causing Encephalitis in North America

Signs of meningeal irritation and increased intracranial pressure should be sought. Neurologic findings reflect the areas of involvement. A careful assessment of cognition is crucial. Sensorimotor deficits are not typical. Encephalitides may show special regional tropism. Herpes simplex virus (HSV) involves limbic structures of the temporal and frontal lobes, with prominent psychiatric features, memory disturbance, and aphasia. Some arboviruses predominantly affect the basal ganglia, causing choreoathetosis and parkinsonism. Involvement of the brainstem nuclei that control swallowing leads to the hydrophobic choking response characteristic of rabies encephalitis.1 I5

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