**Author details**

Hakan Ekmekci1 , Fahrettin Ege<sup>2</sup> and Serefnur Ozturk1\*

\*Address all correspondence to: serefnur.ozturk@noroloji.org.tr

1 Selcuk University, Selcuklu Medical Faculty, Department of Neurology, Konya, Turkey

2 Ufuk University, Medical Faculty, Department of Neurology, Ankara, Turkey

### **References**

[1] Tunkel Ar, Glasser CA, Bloch KC, Sejvar JJ, Marra CM, Roos KL, Hartman BJ, Kaplan SL, Scheld WM, Whitley Rj, Infectious disease society of America. The management of encephalitis: clinical practice guidelines by the infectious diseases society of Amer‐ ica, Clin Infect Dis 47 (2008) 303-327

[2] Rantalaiho T, Farkkila M, Vaheri A, Koskinemiemi M. Acute encephalitis from 1967 to 1991. Journal of the Neurological Sciences 2001; 184: 169 – 177.

**3. Future prospects of CSF studies for viral encephalitis**

**1.** Detection of viral genomic materials

**2.** Evaluation of inflammatory markers

**c.** Differentiation of lytic and lstent viral infectivity

**b.** Macrophage migration inhibitory factor (MIF)

**3.** Evaluation of tissue and neuronal damage products

**4.** Prognostic use of CSF findings in viral encephalitis [1, 3, 7].

must be improved as diagnostic and also prognostic methods.

\*Address all correspondence to: serefnur.ozturk@noroloji.org.tr

, Fahrettin Ege<sup>2</sup>

**a.** RT-PCR, IgM ELISA capture

**a.** IFN-γ, TNF-α, IL-2, IL-6, CD8

**c.** Determination of the antibodies

**a.** NfH-SM135, GFAP-SM126

**b.** S100B

**Author details**

Hakan Ekmekci1

**References**

**b.** Detection of viruses

30 Encephalitis

Current diagnostic methods which have been described above have been providing valua‐ ble proves for diagnostic process of the viral encephalitis but new approaches are needed with increased knowledge of pathogenesis of viral encephalitis. These are must be combined according to clinical picture and possible etiological agents. These promising methods are;

Related to future prospects of diagnostic methods which will evaluate biomarkers in CSF

and Serefnur Ozturk1\*

1 Selcuk University, Selcuklu Medical Faculty, Department of Neurology, Konya, Turkey

[1] Tunkel Ar, Glasser CA, Bloch KC, Sejvar JJ, Marra CM, Roos KL, Hartman BJ, Kaplan SL, Scheld WM, Whitley Rj, Infectious disease society of America. The management

2 Ufuk University, Medical Faculty, Department of Neurology, Ankara, Turkey


[15] Petzold A, Groves M, Leis AA, Scaravilli F, Stokic DS, Neuronal and glial cerebrospi‐ nal fluid protein biomarkers are elevated after west nile virus infection, Muscle Nerve 41 (2010) 42-49

**Chapter 3**

**Spontaneous Intracranial Hypotension: What An**

Although the syndrome of spontaneous intracranial hypotension (SIH) is not an infectious disease, it is commonly involved in the differential diagnoses of meningitis and encephalitis. It is a clinical (headache, fever, even neck stiffness) and laboratory (cerebrospinal fluid (CSF) abnormalities) challenge for the physician. Considering this syndrome especially under some settings and taking care of the charactestic imaging findings would contribute to the diagnosis. We believe in that the physicians who care with these central nervous system (CNS) infections should be aware of this syndrome. Some patients under the suspicion of encephalitis have the SIH that could be diagnosed by approaches described in this chapter.

Patients presenting with fever, headache, stiff neck, nausea, vomiting and some other neuro‐ logical signs suggesting meningeal irritation are always taken seriously and usually have a similar diagnostic algorithm. Differential diagnosis is usually based on the results of CSF analysis. In some cases, characteristics of the headache are the major factor determining the way to establish the diagnosis. Headache with a positional pattern, that occurs shortly after assuming an upright position and relieves by lying down, so called "orthostatic headache"

The spontaneous form of intracranial hypotension was first described by a German neurolo‐ gist Georg Schaltenbrand in 1938 [1]. He recognized that "aliquorrhea," or as subsequently named "hypoliquorrhoea" a deficiency in cerebrospinal fluid, could result in headaches pre‐ dominantly when upright. Since the introduction of magnetic resonance image (MRI) in dai‐

All or essentially all SIH cases are related with a spontaneous spinal CSF leak mostly at the

and reproduction in any medium, provided the original work is properly cited.

© 2013 Balkan and Ozaras; licensee InTech. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

© 2013 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution,

ly diagnostic use in the early 1990s, much has been learned about SIH.

cervicothoracic junction or along the thoracic spine [2].

**Infectious Disease Physician Should Know?**

Ilker Inanc Balkan and Resat Ozaras

is a distinctive symptom of SIH syndrome.

http://dx.doi.org/10.5772/53744

**1. Introduction**

Additional information is available at the end of the chapter

