Monitoring
Survivors must undergo intensive inpatient rehabilitation therapy after hospital discharge if their mental status and functional abilities allow. The extent of their functional recovery should be monitored and documented to make suitable arrangements for their further care and living situation. More specifically, these patients should be monitored for the development of a seizure disorder and treated with appropriate antiepileptic drugs. Some patients can develop hydrocephalus, and may benefit from a permanent cerebrospinal fluid drainage procedure such as placement of a ventriculoperitoneal shunt. Encephalitis may increase risk of ADHD and cognitive problems, especially in the pediatric population.[140] Neuropsychological testing is recommended for survivors of childhood encephalitis.[126][139]
Patients with acute disseminated encephalomyelitis (ADEM) should be followed with serial office visits (to document the appearance of new symptoms). Follow-up MRI brain at 3-6 months is recommended to assess the evolution of ADEM lesions and verify whether they regress in a pattern commonly seen with ADEM.[18] This follow-up imaging can also serve as a baseline for comparison for possible future episodes of acute demyelination.[18] The appearance of new symptoms or new MRI changes a few months after the clinical episode of ADEM raises the suspicion of a chronic demyelinating disease (multiple sclerosis).[150]
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