linked immunosorbent assay (ELISA) can detect IgM
antibodies to arboviruses as a rapid method of diagnosis.
Viral culture from different sites may assist in eventual
diagnosis, but in the author’s opinion is seldom of use in the
acute situation.
Neurological investigation usually starts with cranial
imaging with a computed tomographic (CT) or magnetic
resonance imaging (MRI) scan, primarily to exclude quickly
an intracranial tumour or abscess, but also to yield specific
diagnostic information. MRI is the imaging of choice in
suspected cases of viral encephalitis, although CT scanning
may be used where MRI facilities are not available. CT may be
normal in HSE, especially early in the illness, but characteristically
shows reduced attenuation in one or both temporal
lobes or areas of hyperintensity.7 MRI is sensitive in the early
stages of HSE although rarely it may be normal in this