The Experts below are selected from a list of 7419 Experts worldwide ranked by ideXlab platform
Eric M Deshaies - One of the best experts on this subject based on the ideXlab platform.
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emergency decompressive craniectomy for fulminating Infectious Encephalitis
Journal of Neurosurgery, 2008Co-Authors: Matthew A Adamo, Eric M DeshaiesAbstract:✓In patients who develop fulminant cerebral edema and elevated intracranial pressures, viral Encephalitis can result in devastating neurological and cognitive sequelae despite antiviral therapy. The benefits of decompressive craniectomy, if any, in this group of patients are unclear. In this manuscript, the authors report their experience with 2 patients who presented with herpes simplex virus requiring surgical decompression resulting in excellent neurocognitive outcomes. They also review the literature on decompressive craniectomy in patients with fulminating Infectious Encephalitis. Four published articles consisting of 13 patients were identified in which the authors had reported their experience with decompressive craniectomy for fulminant Infectious Encephalitis. Herpes simplex virus was confirmed in 6 cases, Mycoplasma pneumoniae in 2, and an unidentified viral infection in 5 others. All patients developed clinical signs of brainstem dysfunction and underwent surgical decompression resulting in goo...
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emergency decompressive craniectomy for fulminating Infectious Encephalitis
Journal of Neurosurgery, 2008Co-Authors: Matthew A Adamo, Eric M DeshaiesAbstract:In patients who develop fulminant cerebral edema and elevated intracranial pressures, viral Encephalitis can result in devastating neurological and cognitive sequelae despite antiviral therapy. The benefits of decompressive craniectomy, if any, in this group of patients are unclear. In this manuscript, the authors report their experience with 2 patients who presented with herpes simplex virus requiring surgical decompression resulting in excellent neurocognitive outcomes. They also review the literature on decompressive craniectomy in patients with fulminating Infectious Encephalitis. Four published articles consisting of 13 patients were identified in which the authors had reported their experience with decompressive craniectomy for fulminant Infectious Encephalitis. Herpes simplex virus was confirmed in 6 cases, Mycoplasma pneumoniae in 2, and an unidentified viral infection in 5 others. All patients developed clinical signs of brainstem dysfunction and underwent surgical decompression resulting in good (Glasgow Outcome Scale [GOS] Score 4) or excellent (GOS Score 5) functional recoveries. The authors conclude that Infectious Encephalitis is a neurosurgical disease in cases in which there is clinical and imaging evidence of brainstem compression. Surgical decompression results in excellent recovery of functional independence in both children and adults despite early clinical signs of brainstem dysfunction.
Matthew A Adamo - One of the best experts on this subject based on the ideXlab platform.
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emergency decompressive craniectomy for fulminating Infectious Encephalitis
Journal of Neurosurgery, 2008Co-Authors: Matthew A Adamo, Eric M DeshaiesAbstract:✓In patients who develop fulminant cerebral edema and elevated intracranial pressures, viral Encephalitis can result in devastating neurological and cognitive sequelae despite antiviral therapy. The benefits of decompressive craniectomy, if any, in this group of patients are unclear. In this manuscript, the authors report their experience with 2 patients who presented with herpes simplex virus requiring surgical decompression resulting in excellent neurocognitive outcomes. They also review the literature on decompressive craniectomy in patients with fulminating Infectious Encephalitis. Four published articles consisting of 13 patients were identified in which the authors had reported their experience with decompressive craniectomy for fulminant Infectious Encephalitis. Herpes simplex virus was confirmed in 6 cases, Mycoplasma pneumoniae in 2, and an unidentified viral infection in 5 others. All patients developed clinical signs of brainstem dysfunction and underwent surgical decompression resulting in goo...
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emergency decompressive craniectomy for fulminating Infectious Encephalitis
Journal of Neurosurgery, 2008Co-Authors: Matthew A Adamo, Eric M DeshaiesAbstract:In patients who develop fulminant cerebral edema and elevated intracranial pressures, viral Encephalitis can result in devastating neurological and cognitive sequelae despite antiviral therapy. The benefits of decompressive craniectomy, if any, in this group of patients are unclear. In this manuscript, the authors report their experience with 2 patients who presented with herpes simplex virus requiring surgical decompression resulting in excellent neurocognitive outcomes. They also review the literature on decompressive craniectomy in patients with fulminating Infectious Encephalitis. Four published articles consisting of 13 patients were identified in which the authors had reported their experience with decompressive craniectomy for fulminant Infectious Encephalitis. Herpes simplex virus was confirmed in 6 cases, Mycoplasma pneumoniae in 2, and an unidentified viral infection in 5 others. All patients developed clinical signs of brainstem dysfunction and underwent surgical decompression resulting in good (Glasgow Outcome Scale [GOS] Score 4) or excellent (GOS Score 5) functional recoveries. The authors conclude that Infectious Encephalitis is a neurosurgical disease in cases in which there is clinical and imaging evidence of brainstem compression. Surgical decompression results in excellent recovery of functional independence in both children and adults despite early clinical signs of brainstem dysfunction.
A. Mailles - One of the best experts on this subject based on the ideXlab platform.
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management of Infectious Encephalitis in adults highlights from the french guidelines short version
Revue Neurologique, 2019Co-Authors: L Martinezalmoyna, A. Mailles, T De Broucker, J P StahlAbstract:The article highlights the French clinical guidelines for the management of adult patients with acute Infectious Encephalitis.
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Epidemiology of Infectious Encephalitis causes in 2016
Médecine et Maladies Infectieuses, 2017Co-Authors: A. Boucher, Patrice Morand, J.l. Herrmann, R. Buzelé, A Crabol, A Stahl, A. MaillesAbstract:We performed a literature search in the Medline database, using the PubMed website. The incidence of presumably Infectious Encephalitis is estimated at 1.5-7 cases/100,000 inhabitants/year, excluding epidemics. Infectious Encephalitis and immune-mediated Encephalitis share similar clinical signs and symptoms. The latter accounts for a significant proportion of presumably Infectious Encephalitis cases without any established etiological diagnosis; as shown from a prospective cohort study where 21% of cases were due to an immune cause. Several Infectious agents are frequently reported in all studies: Herpes simplex virus (HSV) is the most frequent pathogen in 65% of studies, followed by Varicella-zoster virus (VZV) in several studies. Enteroviruses are also reported; being the most frequent viruses in two studies, and the 2nd or 3rd viruses in five other studies. There are important regional differences, especially in case of vector-borne transmission: Asia and the Japanese Encephalitis virus, Eastern and Northern Europe/Eastern Russia and the tick-borne Encephalitis virus, Northern America and Flavivirus or Alphavirus. Bacteria can also be incriminated: Mycobacterium tuberculosis and Listeria monocytogenes are the most frequent, after HSV and VZV, in a French prospective study. The epidemiology of Encephalitis is constantly evolving. Epidemiological data may indicate the emergence and/or dissemination of new causative agents. The dissemination and emergence of causative agents are fostered by environmental, social, and economical changes, but prevention programs (vaccination, vector controls) help reduce the incidence of other Infectious diseases and associated Encephalitis (e.g., measles).
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what is new about epidemiology of acute Infectious Encephalitis
Current Opinion in Neurology, 2014Co-Authors: J P Stahl, A. MaillesAbstract:Purpose of review This review aims to describe new features on the epidemiology of Encephalitis world-wide. As this neurological presentation is most frequently related to transmitted viruses, surveillance of Encephalitis is of major importance to detect their emergence or re-emergence. Recent findings Rabies causes one of the most severe types of Encephalitis as it is lethal in all cases, and it is endemic in some countries. It was thought that the virus had been eradicated in Western Europe, but it re-emerged in Greece and Italy. Physicians should be aware of this diagnosis in the case of severe Encephalitis. Some viruses (Powassan, Nipah, and Hendra) are becoming endemic in some new parts of the world (USA and Australia). Because of their severity, they are healthcare concerns in those countries and for travelers (e.g. in Asia). Finally, a concept is emerging: herpes simplex virus is suspected to be a trigger for autoimmune Encephalitis. This is of major importance for the future management of patients (corticosteroids early in the course of the disease?), and the epidemiology of sequelae. Summary Encephalitis is a good marker for the detection of emerging infections. New findings about the relationship between herpes simplex virus Encephalitis and autoimmune Encephalitis open a new concept for a better management of patients.
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autoimmune n methyl d aspartate receptor Encephalitis is a differential diagnosis of Infectious Encephalitis
Journal of Infection, 2014Co-Authors: Laure Thomas, A. Mailles, Virginie Desestret, Francois Ducray, Elodie Mathias, Veronique RogemondAbstract:Summary Background For 60% of acute febrile Encephalitis cases, the cause is unknown. Autoantibodies directed against different synaptic proteins or receptors in patients with autoimmune Encephalitis have recently been described and could indicate a differential diagnosis of Infectious Encephalitis. Objective The aim of this study was to retrospectively investigate the presence of autoantibodies directed against synaptic proteins or receptors in patients with acute febrile Encephalitis. Samples were collected in France in 2007 during a national prospective study. Methods A total of 253 patients with acute febrile Encephalitis were enrolled in 2007. Clinical data were collected with a standardized questionnaire. When possible, cerebrospinal fluid CSF was collected and stored at −80 °C. A total of 108 CSF samples were available for retrospective autoantibody screening. Among the 108 patients, Infectious etiology had been detected in 38 cases (35%); of these 38 patients, 29 (27%) had viral Encephalitis, and 9 (8%) had bacterial Encephalitis. No specific diagnosis was indicated for the other 70 patients (65%). Autoantibodies were detected using a cell-based assay in which HEK293 cells were transfected with plasmids coding for different synaptic proteins or receptors. Results Two patients had anti-NMDA receptor antibodies (NMDAR-Abs), and all patients were negative for anti-Lgi1, CASPR2, GABABR, AMPAR, and mGluR5 antibodies. The two patients with NMDAR-Abs presented neurological and psychiatric symptoms typical of NMDAR-Abs Encephalitis. Conclusions Autoimmune etiology seems to be rare (less than 2%) in patients with acute febrile Encephalitis. However, patients should be systematically screened for the presence of NMDAR-Abs, particularly patients presenting with psychiatric symptoms.
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epidemiology of Infectious Encephalitis differences between a prospective study and hospital discharge data
Epidemiology and Infection, 2013Co-Authors: S Bernard, A. Mailles, J P StahlAbstract:Abstract The French epidemiology of Infectious Encephalitis has been described in a 2007 prospective study. We compared these results with available data (demographic features, causative agents, case-fatality ratio) obtained through the French national hospital discharge 2007 database (PMSI), in order to evaluate it as a surveillance tool for Encephalitis. Causative agents were identified in 52% of cases in the study, and 38% in PMSI (P < 0·001). The incidence of Encephalitis in France in 2007 was estimated as 2·6 cases/100 000 inhabitants. HSV and VZV were the most frequent aetiological agents in both databases with similar rates. Listeria monocytogenes and Mycobacterium tuberculosis were less frequent in PMSI than in the study (Listeria: 2% vs. 5%, P = 0·001; Mycobacterium: 2% vs. 8%, P < 0·001). The case-fatality ratios were similar, except for Listeria (46% in the study vs. 16%). Nevertheless, despite the absence of case definitions and a possible misclassification weakening PMSI data, we suggest that PMSI may be used as a basic surveillance tool at a limited cost.
J P Stahl - One of the best experts on this subject based on the ideXlab platform.
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management of Infectious Encephalitis in adults highlights from the french guidelines short version
Revue Neurologique, 2019Co-Authors: L Martinezalmoyna, A. Mailles, T De Broucker, J P StahlAbstract:The article highlights the French clinical guidelines for the management of adult patients with acute Infectious Encephalitis.
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diagnostic tools to tackle Infectious causes of Encephalitis and meningoEncephalitis in immunocompetent adults in europe
Clinical Microbiology and Infection, 2019Co-Authors: Manuel Schibler, Gilles Eperon, A Kenfak, Agustina M Lascano, Maria Vargas, J P StahlAbstract:Abstract Background Encephalitis and meningoEncephalitis imply inflammation of the brain parenchyma, and comprise many diagnostic entities, such as various infections and causes of dysimmunity. The cause remains unknown in around 50% of cases. Objectives To summarize the main Infectious causes of Encephalitis and meningoEncephalitis acquired in Europe, and the diagnostic means to identify them. Sources PubMed, ECDC and WHO websites, personal experience. Content The principal Infectious causes of Encephalitis and meningoEncephalitis acquired in Europe in adults are discussed in this review, with special emphasis on the microbiological and imaging diagnostic approaches. The role of electroencephalography in diagnosing Encephalitis is also mentioned. Among infections, viruses are more frequent than other pathogen types, and their epidemiology varies according to geographic area. A few bacteria, such as Listeria monocytogenes and Mycobacterium tuberculosis, are also to be considered. In contrast, parasites and fungi are rare Encephalitis causes in Europe. Implications Identifying the causative pathogen of Infectious Encephalitis and meningoEncephalitis is complex because of the variety of pathogens, the epidemiology of which is determined by geography and environmental factors. Furthermore, despite extensive microbiological testing, many cases of Encephalitis remain of unknown origin. Brain magnetic resonance imaging and electroencephalography are useful complementary diagnostic tools, and newer unbiased sequencing technologies might help to fill in the diagnostic gap.
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management of adult Infectious Encephalitis in metropolitan france
Medecine Et Maladies Infectieuses, 2017Co-Authors: T Goulenok, R. Buzelé, Xavier Duval, Fabrice Bruneel, J P Stahl, B FantinAbstract:Infectious Encephalitis is a severe disease leading to a high mortality and morbidity. The most frequent causes include Herpes simplex virus, Varicella Zoster virus, Listeria monocytogenes, and Mycobacterium tuberculosis. Urgent treatment is required (anti-infective therapy and nonspecific supportive care). The aim of this study was to define treatment strategy, empirical and after microbiological documentation at 48hours, through a systematic literature review.
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what is new about epidemiology of acute Infectious Encephalitis
Current Opinion in Neurology, 2014Co-Authors: J P Stahl, A. MaillesAbstract:Purpose of review This review aims to describe new features on the epidemiology of Encephalitis world-wide. As this neurological presentation is most frequently related to transmitted viruses, surveillance of Encephalitis is of major importance to detect their emergence or re-emergence. Recent findings Rabies causes one of the most severe types of Encephalitis as it is lethal in all cases, and it is endemic in some countries. It was thought that the virus had been eradicated in Western Europe, but it re-emerged in Greece and Italy. Physicians should be aware of this diagnosis in the case of severe Encephalitis. Some viruses (Powassan, Nipah, and Hendra) are becoming endemic in some new parts of the world (USA and Australia). Because of their severity, they are healthcare concerns in those countries and for travelers (e.g. in Asia). Finally, a concept is emerging: herpes simplex virus is suspected to be a trigger for autoimmune Encephalitis. This is of major importance for the future management of patients (corticosteroids early in the course of the disease?), and the epidemiology of sequelae. Summary Encephalitis is a good marker for the detection of emerging infections. New findings about the relationship between herpes simplex virus Encephalitis and autoimmune Encephalitis open a new concept for a better management of patients.
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epidemiology of Infectious Encephalitis differences between a prospective study and hospital discharge data
Epidemiology and Infection, 2013Co-Authors: S Bernard, A. Mailles, J P StahlAbstract:Abstract The French epidemiology of Infectious Encephalitis has been described in a 2007 prospective study. We compared these results with available data (demographic features, causative agents, case-fatality ratio) obtained through the French national hospital discharge 2007 database (PMSI), in order to evaluate it as a surveillance tool for Encephalitis. Causative agents were identified in 52% of cases in the study, and 38% in PMSI (P < 0·001). The incidence of Encephalitis in France in 2007 was estimated as 2·6 cases/100 000 inhabitants. HSV and VZV were the most frequent aetiological agents in both databases with similar rates. Listeria monocytogenes and Mycobacterium tuberculosis were less frequent in PMSI than in the study (Listeria: 2% vs. 5%, P = 0·001; Mycobacterium: 2% vs. 8%, P < 0·001). The case-fatality ratios were similar, except for Listeria (46% in the study vs. 16%). Nevertheless, despite the absence of case definitions and a possible misclassification weakening PMSI data, we suggest that PMSI may be used as a basic surveillance tool at a limited cost.
Angela Colantonio - One of the best experts on this subject based on the ideXlab platform.
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systematic review of rehabilitation intervention outcomes of adult and paediatric patients with Infectious Encephalitis
BMJ Open, 2018Co-Authors: Shanice Christie, Vincy Chan, Tatyana Mollayeva, Angela ColantonioAbstract:Objective Although a range of rehabilitation interventions have been applied to restore function after Infectious Encephalitis, there is a lack of literature summarising the benefits of these interventions. This systematic review aims to synthesise current scientific knowledge on outcome measures following rehabilitative interventions among children and adults with Infectious Encephalitis, with a specific focus on the influence of the age, sex, baseline status and intervention type. Search strategy Five scholarly databases (MEDLINE, Embase, PsycINFO, CINAHL and Cochrane Central Register of Controlled Trials), three sources of grey literature (Google, Google Scholar and Grey Matters) and reference lists of included publications were systematically searched. Literature published before 15 December 2017 and focused on patients with Infectious Encephalitis in any rehabilitation setting were included. Quality assessment was completed using the Downs and Black rating scale. Results Of the 12 737 reference titles screened, 20 studies were included in this review. All of the studies had sample sizes of less than 25 patients and received a score of less than 15 out of 31 points on the Downs and Black rating scale. Findings showed a variety of interventions has been applied to alleviate sequelae from Infectious Encephalitis, including using cognitive therapy (nine studies), behavioural therapy (five studies), physical therapy (two studies) or two or more therapies (four studies). There was inconclusive evidence on the effect of sex, age and baseline functional abilities on outcomes. Due to clinical and methodological heterogeneity between studies, meta-analyses were not performed. Conclusion Evidence suggests the potential for a beneficial effect of rehabilitation interventions in patients with Infectious Encephalitis. Future research is required to identify all effect modifiers and to determine the effect of time in the natural course of recovery. An enhanced set of known effect modifiers will support the process of future evaluation of a client-centred rehabilitation intervention. Trial registration number CRD42015029217.
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rehabilitation interventions in children and adults with Infectious Encephalitis a systematic review protocol
BMJ Open, 2016Co-Authors: Shanice Christie, Vincy Chan, Tatyana Mollayeva, Angela ColantonioAbstract:Introduction Many Encephalitis survivors can benefit from rehabilitation. However, there is currently no comprehensive review describing rehabilitation intervention outcomes among children and adults with Infectious Encephalitis. This is a protocol for a systematic review that will summarise the current literature on outcomes following rehabilitative interventions among children and adults with Infectious Encephalitis. With a sufficient sample size, a sex-stratified analysis of the findings will also be presented, as variability between male and female patients with neurological disorders, including Encephalitis, regarding outcomes after rehabilitative interventions has been noted in the literature. Methods and analysis This review will systematically search MEDLINE, MEDLINE In-Process, EMBASE, Cochrane Central Register of Controlled Trials, and PsycINFO using the concepts ‘Encephalitis’ and ‘rehabilitation’. Grey literature will be searched using Grey Matters: A practical search tool for evidence-based medicine and the Google search engine. In addition, reference lists of eligible articles will be screened for any relevant studies. 2 reviewers will independently evaluate the retrieved studies based on predetermined eligibility criteria and perform a quality assessment on eligible studies. Ethics and dissemination The results from this review hold the potential to advance our knowledge on the value of rehabilitative interventions targeting children and adults with Infectious Encephalitis and any sex differences among patients with regard to rehabilitative intervention outcomes. The authors will publish findings from this review in a peer-reviewed scientific journal (electronic and in-print) and present the results at national and international conferences. Trial registration number CRD42015029217.