Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Is This Symptom Of Refractory Seizures, Most Likely Due To Some Form Of Encephalitis?
Question: One of my team members has his wife in the ICU. She had fever of a week's duration and after three days the reports say she could not speak and as reported by my team member, she was having seizures. Autoimmune encephalitis was initially suspected but tests have proven negative. On ventilator now. O is seeking an expert second opinion and I thought I would post here. Please see attached report
Current state is Super-refractory status epilepticus (SRSE). One question is, is the antiviral treatment broad enough ? (Acycovir). Also, do you recommend any change to medication ?
SO far malaria dengue, HSV , meningitis biofire panel all tested negative
SO far malaria dengue, HSV , meningitis biofire panel all tested negative
Brief Answer:
The diagnosis is still not clear
Detailed Answer:
We understand your concern. The patient had refractory seizures, most likely due to some form of encephalitis. But none of the tests have proven any conclusive evidence of the likely cause. The approach of the treating doctors seems fine since the final diagnosis is still not clear. Both the provisional diagnosis are equally possible including viral and seronegative autoimmune encephalitis. In my opinion the same treatment should be continued. The antiviral being given is a broad spectrum medicine. Take care.
Thanks.
The diagnosis is still not clear
Detailed Answer:
We understand your concern. The patient had refractory seizures, most likely due to some form of encephalitis. But none of the tests have proven any conclusive evidence of the likely cause. The approach of the treating doctors seems fine since the final diagnosis is still not clear. Both the provisional diagnosis are equally possible including viral and seronegative autoimmune encephalitis. In my opinion the same treatment should be continued. The antiviral being given is a broad spectrum medicine. Take care.
Thanks.
Above answer was peer-reviewed by :
Dr. Saisudha Kotla
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
