Aseptic meningoencephalitis mimicking transient ischaemic attacks.

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Serval ID
serval:BIB_1274B965F1D6
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Aseptic meningoencephalitis mimicking transient ischaemic attacks.
Journal
Infection
Author(s)
Papavasileiou V., Milionis H., Cordier M., Eskandari A., Ntaios G., Michel P.
ISSN
1439-0973 (Electronic)
ISSN-L
0300-8126
Publication state
Published
Issued date
2013
Volume
41
Number
2
Pages
485-491
Language
english
Notes
Publication types: Journal ArticlePublication Status: ppublish
Abstract
PURPOSE: To highlight meningoencephalitis as a transient ischaemic attack (TIA) mimic and suggest clinical clues for differential diagnosis.
METHODS: This was an observational study of consecutively admitted patients over a 9.75-year period presenting as TIAs at a stroke unit.
RESULTS: A total of 790 patients with TIAs and seven with TIA-like symptoms but a final diagnosis of viral meningoencephalitis were recognised. The most frequent presentations of meningoencephalitis patients were acute sensory hemisyndrome (6) and cognitive deficits (5). Signs of meningeal irritation were minor or absent on presentation. Predominantly lymphocytic pleocytosis, hyperproteinorachia and a normal cerebrospinal fluid (CSF)/serum glucose index (in 5 out of 6 documented patients) were present. Meningeal thickening on a brain magnetic resonance imaging (MRI) scan was the only abnormal imaging finding. Six patients received initial vascular treatment; one thrombolysed. Finally, six patients were treated with antivirals and/or antibiotics. Although neither bacterial nor viral agents were identified on extensive testing, viral meningoencephalitis was the best explanation for all clinical and laboratory findings.
CONCLUSIONS: Aseptic meningoencephalitis should be part of the differential diagnosis in patients presenting as TIA. The threshold for a lumbar puncture in such patients should be set individually and take into account the presence of mild meningeal symptoms, age and other risk factors for vascular disease, the results of brain imaging and the basic diagnostic work-up for a stroke source.
Pubmed
Web of science
Open Access
Yes
Create date
25/04/2013 16:52
Last modification date
01/10/2019 6:16
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