treatment

Last reviewed 01/2018

Treatment is usually empirical to begin with, unless there is a clear idea of the aetiology. Thus, modalities include:

  • intravenous acyclovir, to cover herpes simplex. Given before the patient enters coma, this treatment has massively improved the prognosis.
  • intravenous broad spectrum antibiotics
  • intravenous mannitol, to reduce cerebral oedema
  • intravenous dextrose or dextrose sailine, to maintain the blood glucose. The usual fluid management is restriction to two thirds maintenance, again to reduce cerebral oedema.

Other measures are supportive.

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