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Diagnosis of Encephalitis not confirmed.
1. Female, aged 62. Symptoms.—Feverish attack for three days. Temperature
101. Pain in back and arm. Drowsiness 10 days. Result.—After removal to
hospital—diagnosis of mental disorder, delusions and history of suicidal tendency.
2. Female, aged 55. Symptoms.—Sudden " Fit."—unconscious, vomiting, convergent
squint and diplopia. Insomnia. Later—drowsiness. Result.—Complete
recovery in hospital. Diagnosis.—Cerebral arteriosclerosis. High blood
pressure causing cerebral haemorrhage. Later—returned home. Death occurred
two months afterwards from sudden apoplexy.
In three cases the clinical features did not suggest encephalitis and the diagnosis
was amended and subsequently confirmed as follows:—
1. Male, aged 8.—Original diagnosis—Tuberculous meningitis or encephalitis.
Symptoms.—Headache and pain in left eye. Temperature 102. Drowsiness.
Painful swelling of left orbit. Amended diagnosis.—Orbital cellulitis as the
result of blow. Progress.—Complete recovery.
2. Male, aged 32. Original diagnosis.—Encephalitis lethargica(?) Symptoms.—
Sudden faintness and loss of consciousness. Fall on head, giddiness, headache,
vomiting. Amended diagnosis.—Cerebral concussion. Progress.—Prompt relief
following lumbar puncture and withdrawal of 30 c.c. blood-tinged but normal
cerebro-spinal fluid. Rapid recovery.
3. Female, aged 45.—Original diagnosis.—Encephalitis (?). Symptoms.—Headache,
slight ptosis. Amended diagnosis.—Migraine. Progress.—Cerebral
haemorrhage, slow improvement.
Of three cases originally diagnosed as presenting postencephalitic sequelae one only
could be regarded as probably attributable to an attack of encephalitis, and one
possibly so.
1. Male, aged 15 months. Symptoms.—Initial attack. Internal squint and
drowsiness at 4 months. Later, convulsive attacks and vomiting. Sequel.—
Arrested mental development.
2. Female, aged 19. Symptoms.—Two months' inability to concentrate on her
work. Severe headaches, emotional, hiccup. Diagnosis.—Evidence in favour
of initial encephalitis uncertain ; neurasthenia.
3. Male, aged 11. Sytnptoms.—Raised temperature. Diplopia and slight squint.
Diagnosis.—No evidence of encephalitis. Defective vision requiring correction
by glasses.
Cases provisionally diagnosed as possible but doubtful cerebrospinal fever or other
form of meningitis or poliomyelitis.
1. Female, aged 69. Symptoms.—Headache, drowsiness, pains in limbs, petechial
eruption on trunk and legs, raised temperature. Diagnosis.—No evidence of
meningitis, probably rheumatic purpura. Result.—In hospital—acute lymphatic
leucaemia, determined by blood examination. Death four days later.
2. Male, aged 4. Symptoms.—Raised temperature, pain in back of neck, slight
squint and twitching of eyelids. Erythema. Diagnosis.—No evidence of meningitis
or encephalitis, probably influenza. Result.—Rapid recovery—Influenza.
3. Female, aged 13 months. Symptoms.—Raised temperature, drowsy, irritable,
squint. Diagnosis.—No evidence of meningitis or poliomyelitis. Condition
due to teething, and gastric disturbance. Result.—Rapid recovery—Teething
and Constipation.
4. Female, aged 7.—Symptoms.—Following tonsillectomy raised temperature to
104 and 105. Diagnosis.—No evidence of meningitis. Septicaemia. Result.—
On removal to hospital gradual recovery from septicaemia.
5. Female, aged 3.—Symptoms.—Diarrhoea, sore throat and pains in leg. Raised
temperature, (?) poliomyelitis. Diagnosis.—No evidence of poliomyelitis, probably
Influenza. Result.—Rapid recovery. Influenza.
13651 C 2