So how do we treat viral encephalitis? Well the treatment really begins with supportive care,
just like any other viral process. Many of these patients will also present with seizure and
treatment of seizure is needed if indicated. Patients that have a seizure should be treated,
we don't always prophylax. But in severe cases and in particular with herpes encephalitis
where seizures are so common, antiepileptic treatment is often used. What about viral
agents? We don't use antiviral therapy for all patients, but there are certain indications. IV
acyclovir is used for herpes, varicella, and Epstein-Barr encephalitis. Ganciclovir, foscarnet
has been shown to be effective for CMV encephalitis which can cause a severe ventriculitis.
And ribavirin is used for La Crosse encephalitis, which is also called California encephalitis.