[Acute viral encephalitis with primary psychotic symptoms--diagnosis, course and prognosis].

In 13 cases referred to psychiatric treatment between 1974 and 1980 acute viral encephalitis was diagnosed in the further course of the illness. The majority were female patients. Positive virological or pathological evidence was obtained in 38% of all cases. The most frequent etiology to be found was the herpes-simplex virus. These findings correspond to 36 cases from the literature. 90% of all cases showed neurological symptoms within two weeks of hospital admission. EEG and cerebrospinal fluid examinations proved to yield most in diagnosis, whereas angiography and brain scanning did not have special diagnostic importance. The present diagnostic value of CT is mainly restricted to the detection of herpes-simplex virus encephalitis and acute leukoencephalitis. Initially psychopathological findings varied largely and fluctuations in the level of consciousness were a prominent feature in most cases. In others no difference to schizophrenic psychosis could be noted on admission. Compared to other studies on acute viral encephalitis with initial neurological symptoms, patients with a psychotic onset of the illness tend to have a higher morbidity, while the mortality remains the same.