Encephalitis or Mild Encephalitis or Neuroprogression or Encephalopathy-not merely a question of terminology
- 1Dept. Psychiatry and Psychotherapy II, Ulm University, Bezirkskrankenhaus Günzburg, Germany
Meningoencephalitis and encephalitis are comparably well-defined clinical terms in neuropsychiatry, although in the individual case approach diagnosis can be difficult, for example some cases of encephalitis described with normal cerebrospinal fluid findings, or often in chronic encephalitis. Encephalopathy is also a widely accepted term, however with a surprisingly broad meaning with regard to the assigned underlying pathophysiology, ranging from one- hit traumatic encephalopathy to inflammatory encephalopathy, the latter a type of brain dysfunction secondary to acute systemic inflammation without proven brain autochthonus inflammation , ie. neuroinflammation. However, this latter assumption may be wrong as neuroinflammation is difficult to prove in vivo. With emerging insights into prevailing inflammatory and neuroinflammatory mechanisms to be involved in the pathogenesis of severe mental disorders, the interdependent question of sensitive assessment and clinical relevance of mild neuroinflammation is of increasing interest. The traded clinical terms and the newly proposed terms of mild encephalitis, parainflammation and neuroprogression are therefore reconsidered here with regard to emerging clinical relevance and respective borders, gaps and overlap in between. Categorical delineation of the terms with respect to individualised psychiatric treatment is required and preliminary attempted here on the basis of available data.
Keywords: Meningoencephalitis, Encephalitis, Neuroinflammation, Inflammation, parainflammation
Received: 23 Aug 2018;
Accepted: 28 Dec 2018.
Edited by:Stefan Borgwardt, Universität Basel, Switzerland
Reviewed by:Drozdstoy S. Stoyanov, Plovdiv Medical University, Bulgaria
Joachim Klosterkötter, Universität zu Köln, Germany
Copyright: © 2018 Bechter. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Prof. Karl Bechter, Dept. Psychiatry and Psychotherapy II, Ulm University, Bezirkskrankenhaus Günzburg, Ulm, Germany, Karl.Bechter@bkh-guenzburg.de