Answer the following questions by circling the letter of the correct answer.
The following statements correctly refer to acute demyelinating encephalomyelitis (ADEM) except for:
generally follows acute non-neurological infectious illness by one to three weeks;
disease of the white matter characterized by demyelination;
encephalopathy (altered or fluctuating state of consciousness including profound lethargy) and variable neurological findings including ataxia, decreased deep tendon reflexes, urinary retention and bilateral optic neuritis are present;
highly suggestive magnetic resonance imaging findings with variable cerebrospinal fluid (CSF) findings;
lack of responsiveness to steroid therapy.
The following statements correctly refer to acute viral encephalitis:
represents an uncommon response to a common infection;
disease of grey matter;
encephalopathy (altered or fluctuating state of consciousness including profound lethargy) and variable neurological findings including ataxia, decreased deep tendon reflexes, urinary retention, and bilateral optic neuritis are present;
inflammation of the brain parenchyma manifest as CSF pleocytosis at some point in illness but not necessarily on admission to hospital;
the outcome, favourable or otherwise, can be reliably predicted clinically within the first weeks of illness.
Contemporary management of the child with suspected acute encephalitis who is severely ill or fails to recover in 24 to 48 h includes the following except:
diagnostic testing of (1) blood collected acutely (5 mL) and in convalescence (two to six weeks later) and (2) viral detection with either culture or antigen detection (CSF, throat, stool, urine, blood as applicable);
EEG +/− evoked potentials;
no transfer to tertiary care centre.
Noninfectious conditions that can cause encephalopathy include the following except:
endocrine and metabolic disorders;
hepatic or renal failure;
mitochondrial defects and inborn errors of metabolism.
Infections that can mimic viral encephalitis include the following except:
brain abscess and parameningeal infection;
subacute bacterial endocarditis;
Therapy is available for encephalitis of the following etiologies except for:
cat scratch disease;
See page 56 for the correct answers
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