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By C A Bartzokas; G W Smith

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Med. 314: 144–149. A. D. et al. for the NIAID Collaborative Antiviral Study Group. (1989) Diseases that mimic herpes simplex encephalitis: diagnosis, presentation, and outcome. JAMA 262: 234–239. qxd 13/08/98 14:53 Page 25 4 Transmissible neurodegenerative diseases Creutzfeld-Jakob disease (CJD) Initial symptoms lasting a few weeks are often vague and include changes in mood (often mild depression), personality and sleep disturbance. These progress to a rapidly evolving dementia (over the course of several weeks to a few months) with disturbance of balance (ataxia), visual distortions, visual hallucinations, dysarthria and the development of stimulus sensitive myoclonus.

1984) Acyclovir versus vidaribine therapy in herpes simplex encephalitis: a randomised multicentre study in consecutive Swedish patients. Lancet ii: 707–711. J. (1990) Viral encephalitis. N. Engl. J. Med. 323: 242–250. , et al. and the NIAID Collaborative Antiviral Study Group. (1986) Vidaribine versus aciclovir therapy in herpes simplex encephalitis. N. Engl. J. Med. 314: 144–149. A. D. et al. for the NIAID Collaborative Antiviral Study Group. (1989) Diseases that mimic herpes simplex encephalitis: diagnosis, presentation, and outcome.

Tell the patient that treatment will be initiated and that if their condition fails to respond they will subsequently be referred. v. 5 cm diameter, without significant mass effect). ✓ Will not overload scarce neuroscience facilities. ✗ If medical management is insufficient and the patient deteriorates, neurosurgical inter- vention carries a greater risk. ✗ Window of therapeutic opportunity may well be lost. ✗ Does not allow an early microbiological diagnosis since stereotactic aspiration cannot be performed.

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