Encephalitis: Viral - Treatment

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Highlights	Risk Factors	Vaccinations
Introduction	Prognosis	Prevention
Causes	Diagnosis	Resources
Symptoms	Treatment	References

About 25% of patients who have been successfully treated for herpes encephalitis have a relapse. Early diagnosis and treatment may help reduce this risk. Doctors are investigating if a 3-month course of oral valacyclovir will improve remission rates after a patient completes treatment with intravenous acyclovir. Foscarnet (Foscavir), another powerful antiviral drug known as a pyrophosphate analogue, may be useful for herpes simplex viral strains that have become resistant to acyclovir.

Investigational Treatments for West Nile Virus and Other Arboviruses

There are no drugs that have been effective for treating arboviruses, including West Nile virus. A number of drugs used to treat other virus infections are being investigated. They include ribavirin (an antiviral drug used to treat influenza), interferon alfa 2a (Roferon-A) and other interferons, immunoglobulin G, and glycyrrhizin (a compound in licorice root with anti-viral activity). Researchers with the U.S. National Institutes of Health are investigating Omr-IgG-am, a blood-derived product that contains WNV antibodies, which can be given intravenously.

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Treatment for Acute Disseminated Encephalomyelitis (ADEM)

ADEM is usually treated with high-dose intravenous methylprednisolone, a powerful anti-inflammatory drug known as a corticosteroid. Intravenous immunoglobulin (IVIG), alone or in combination with methylprednisolone, is also showing promise in certain patients, including children with severe ADEM.

Recombinant erythropoietin epoetin alfa (Epogen, Procrit, AraNESP), a genetically engineered drug that stimulates the production of red blood cells, may also help protect the brain. Experimental work suggests it may be helpful for patients with ADEM.

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Review Date: 01/18/2007
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital

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