Sec14-x5974 881..976

Influenzal encephalitis is frequently treated with oral antivirals, including amantadine (Symmetrel) for influenza A (if susceptible), rimantadine (Flumadine) for influenza A (if susceptible), and oseltamivir (Tamiflu) for influenza A and B; corticosteroids and immune globulin have also been tried. However, none of these agents has been proven to be effective for influenzal encephalitis. A combination of antiviral treatment, corticosteroids, and intravenous immune globulin has been suggested to reduce mortality due to influenzal acute necrotizing encephalopathy. There currently are no established therapies for West Nile virus encephalitis. Ribavirin (Rebetol), interferon, high-titer immune globulin, and corticosteroids have been used, and therapeutic trials are currently ongoing. No specific therapies have been proven to be effective for encephalitis due to other arboviruses or for rabies; successful use of coma-inducing therapy plus the antivirals ribavirin and amantadine was reported in one patient with rabies encephalitis. Corticosteroids, intravenous immune globulin, and plasmapheresis have been used for acute disseminated encephalomyelitis, but efficacy trials have not been performed.