CNS infections

Question 1

where does herpes simplex encephalitis characteristically affect

Answer 1

temporal lobes (aphasia)
also affects inferior frontal lobes

Question 2

features of herpes simplex encephalitis

Answer 2

fever, headache, psychiatric symptoms, seizures, vomiting
focal features (aphasia)

Question 3

investigations in herpes simplex encephalitis

Answer 3

CSF: lymphocytosis, elevated protein
PCR for HSV
CT: medial temporal and inferior frontal changes (hypodensities)
MRI is better
bilateral temporal lobe changes

Question 4

treatment for herpes simplex encephalitis

Answer 4

IV aciclovir

Question 5

what to look out for in diagnosis of autoimmune encephalitis

Answer 5

malignancy
- small cell lung cancer
- ovarian teratoma

Question 6

what patients get cryptococcal meningoencephalitis

Answer 6

severe immunodeficiency (AIDS)
symptoms progress over weeks

Question 7

CSF findings in bacterial meningitis

Answer 7

cloudy
low glucose
high protein
white cells: 10-5000

Question 8

complications of meningitis

Answer 8

sensorineural hearing loss
seizures
focal neurological deficit
infective: sepsis or intracerebral abscess
pressure: brain herniation, hydrocephalus