California Encephalitis Clinical Presentation
- Author: Wayne E Anderson, DO; Chief Editor: Burke A Cunha, MD more...
History and Physical Examination
The incubation period of California encephalitis is usually 3-7 days. A prodromal phase of 1-4 days commonly precedes the onset of encephalitis. This phase manifests as any or all of the following:
- Fever
- Chills
- Nausea
- Vomiting
- Headache
- Abdominal pain
The encephalitis is characterized by fever, somnolence, and obtundation. Seizures occur in 50% of children. Periodic lateralizing epileptiform discharges (PLEDS) can be seen in the temporal lobe. Twenty percent of children develop focal neurologic signs (eg, asymmetrical reflexes, Babinski signs), and 10% of patients develop coma. The total duration of illness rarely exceeds 10-14 days. Epilepsy develops in 20% of patients, especially those who had seizures during the acute illness.
Two reports in the literature have described LaCrosse encephalitis manifesting as signs and symptoms of herpes simplex encephalitis.[2, 3]
In adults, infection is asymptomatic or causes a benign febrile illness or aseptic meningitis.
Physical findings may include the following:
- Fever
- Lethargy
- Focal neurologic findings (eg, aphasia)
- Incoordination
- Focal motor abnormalities
- Paralysis
Halperin JJ, ed. Encephalitis: Diagnosis and Treatment. New York, NY: Informa Healthcare; 2008.
Sokol DK, Kleiman MB, Garg BP. LaCrosse viral encephalitis mimics herpes simplex viral encephalitis. Pediatr Neurol. Nov 2001;25(5):413-5. [Medline].
Wurtz R, Paleologos N. La Crosse encephalitis presenting like herpes simplex encephalitis in an immunocompromised adult. Clin Infect Dis. Oct 2000;31(4):1113-4. [Medline].
de los Reyes EC, McJunkin JE, Glauser TA, Tomsho M, O'Neal J. Periodic lateralized epileptiform discharges in La Crosse encephalitis, a worrisome subgroup: clinical presentation, electroencephalogram (EEG) patterns, and long-term neurologic outcome. J Child Neurol. Feb 2008;23(2):167-72. [Medline].
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