naa a22 4500 510799299 CHVBK 20180411083348.0 cr unu---uuuuu 180411e20130801xx s 000 0 eng 10.1007/s12028-013-9822-5 doi (NATIONALLICENCE)springer-10.1007/s12028-013-9822-5 Successful Management of Severe Neuroinvasive Eastern Equine Encephalitis [Elektronische Daten] [Linda Wendell, N. Potter, Julie Roth, Stephen Salloway, Bradford Thompson] Background: Eastern Equine Encephalitis (EEE) virus is an arbovirus that mostly causes asymptomatic infection in humans; however, some people can develop a neuroinvasive infection associated with a high mortality. Methods: We present a case of a patient with severe neuroinvasive EEE. Results: A 21-year-old man initially presented with headache, fever, and vomiting and was found to have a neutrophilic pleocytosis in his cerebrospinal fluid. He eventually was diagnosed with EEE, treated with high-dose methylprednisolone and intravenous immunoglobulin. His course in the NeuroIntensive Care Unit was complicated by cerebral edema and intracranial hypertension, requiring osmotherapy, pentobarbital and placement of an external ventricular device, and subclinical seizures, necessitating multiple anti-epileptic drugs Conclusions: A multifaceted approach including aggressive management of cerebral edema and ICP as well as treatment with immunomodulating agents and cessation of seizures may prevent brain herniation, secondary neurologic injury and death in patients with EEE. Effective management and treatment in our patient contributed to a dramatic recovery and ultimate good outcome. Springer Science+Business Media New York, 2013 Eastern Equine Encephalitis nationallicence Intracranial hypertension nationallicence Cerebral edema nationallicence Seizure nationallicence Wendell Linda Departments of Neurology and Neurosurgery, Rhode Island Hospital/Warren Alpert School of Medicine at Brown University, 593 Eddy Street, APC 712, 02903, Providence, RI, USA aut Potter N. Departments of Neurology and Neurosurgery, Rhode Island Hospital/Warren Alpert School of Medicine at Brown University, 593 Eddy Street, APC 712, 02903, Providence, RI, USA aut Roth Julie Department of Neurology, Rhode Island Hospital/Warren Alpert School of Medicine at Brown University, Providence, RI, USA aut Salloway Stephen Departments of Neurology, Butler Hospital/Warren Alpert School of Medicine at Brown University, Providence, RI, USA aut Thompson Bradford Departments of Neurology and Neurosurgery, Rhode Island Hospital/Warren Alpert School of Medicine at Brown University, 593 Eddy Street, APC 712, 02903, Providence, RI, USA aut Neurocritical Care Springer US; http://www.springer-ny.com 19/1(2013-08-01), 111-115 1541-6933 19:1<111 2013 19 12028 https://doi.org/10.1007/s12028-013-9822-5 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s12028-013-9822-5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Wendell Linda Departments of Neurology and Neurosurgery, Rhode Island Hospital/Warren Alpert School of Medicine at Brown University, 593 Eddy Street, APC 712, 02903, Providence, RI, USA aut NATIONALLICENCE 700 1- Potter N. Departments of Neurology and Neurosurgery, Rhode Island Hospital/Warren Alpert School of Medicine at Brown University, 593 Eddy Street, APC 712, 02903, Providence, RI, USA aut NATIONALLICENCE 700 1- Roth Julie Department of Neurology, Rhode Island Hospital/Warren Alpert School of Medicine at Brown University, Providence, RI, USA aut NATIONALLICENCE 700 1- Salloway Stephen Departments of Neurology, Butler Hospital/Warren Alpert School of Medicine at Brown University, Providence, RI, USA aut NATIONALLICENCE 700 1- Thompson Bradford Departments of Neurology and Neurosurgery, Rhode Island Hospital/Warren Alpert School of Medicine at Brown University, 593 Eddy Street, APC 712, 02903, Providence, RI, USA aut NATIONALLICENCE 773 0- Neurocritical Care Springer US; http://www.springer-ny.com 19/1(2013-08-01), 111-115 1541-6933 19:1<111 2013 19 12028 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer