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Emergency Neurologic Life Support: Meningitis and Encephalitis

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Abstract

Bacterial meningitis and viral encephalitis, particularly herpes simplex encephalitis (HSE), are severe neurological infections that, if not treated promptly and effectively, lead to poor neurological outcome or death. Because treatment is more effective if given early, the topic of meningitis and encephalitis was chosen as an Emergency Neurological Life Support protocol. This protocol provides a practical approach to recognition of and urgent treatment for bacterial meningitis and HSE, including imaging and spinal fluid analysis, and discusses the choice of empirical treatments until the cause of infection is determined. Though uncommon in its full form, the typical clinical triad of headache, fever, and neck stiffness should alert the clinical practitioner to the syndromes. Early attention to the airway and maintaining normotension is crucial in treatment of these patients, as is rapid treatment with anti-infectives and, in some cases, corticosteroids.

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Authors and Affiliations

  1. Department of Emergency Medicine and Center for Resuscitation Science, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

    David F. Gaieski

  2. Division of Neurocritical Care, Department of Neurology, University of Virginia, Charlottesville, VA, USA

    Barnett R. Nathan

  3. ENLS Course Co-Chair, Division of ED Critical Care, Mount Sinai School of Medicine, New York, NY, USA

    Scott D. Weingart

  4. ENLS Course Co-Chair, Department of Neurology, University of California, San Francisco, CA, USA

    Wade S. Smith

Authors
  1. David F. Gaieski
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  2. Barnett R. Nathan
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  3. Scott D. Weingart
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  4. Wade S. Smith
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Correspondence to David F. Gaieski.

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Gaieski, D.F., Nathan, B.R., Weingart, S.D. et al. Emergency Neurologic Life Support: Meningitis and Encephalitis. Neurocrit Care 17 (Suppl 1), 66–72 (2012). https://doi.org/10.1007/s12028-012-9751-8

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  • DOI: https://doi.org/10.1007/s12028-012-9751-8

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