BSN Notes: Neurology- Encephalitis

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Encephalitis


Inflammation of brain.

·               Commonly diagnosed cause is viral infection
·          Bacteria , fungi and parasites
·          Common viral causes of encephalitis include Herpes simplex virus , epstein barr virus, varicella zoster virus , enteroviruses, arboviruses Arthropod borne viruses, tick borne viruses and rabies viruses
Types of encephalitis
  • ·          Infectious encephalitis: viral encephalitis may develop during or after infection with any of several viral illnesses including influenza, herpes simplex, measles, mumps, rubella, rabies, and chickenpox.
  •    Post infectious encephalitis: this can occur many days, weeks, or sometimes months after the initial infection e.g. Previous infection/vaccine.
  • Autoimmune encephalitis
  •  Japanese encephalitis: is a viral infection that is spread by mosquitoes. The condition occurs throughout south asia, the far east and pacific islands.
  •  Chronic encephalitis: the inflammation develops slowly over many months; it can be a result of a condition such as HIV

Clinical manifestations
·          It begins with flu like symptoms
·          High temperature
·          Severe headache
·          Nausea and vomiting
·          After initial stage , more severe symptoms develop
·          Changes in mental state- confusion, drowsiness/ disorientation
·          Seizures
·          Loss of consciousness
·          Photophobia

Diagnostic evaluation
·          CT and MRI scan
·          Brain biopsy
·          Culture of CSF, blood.
·          Lumbar puncture and CSF examination
·          Serology tests (test that detect antibodies to a virus)
            Management
·          The goals of treatment are to provide supportive care (rest, nutrition , fluids) to help the body to fight infection and to relieve symptoms
·          Reorientation and emotional support for confused or delirious people may be helpful
·          Anti-inflammatory drugs — such as acetaminophen, ibrufen are administered to relieve headache and fever.
·          Antiviral medications — acyclovir — to treat herpes encephalitis or other severe viral infections  
·          Autoimmune encephalitis — can be treated with corticosteroids , immunoglobulin therapy and plasmapheresis
·          Cyclosporine is a widely used immunosuppressant in the treatment of autoimmune encephalitis
Supportive care
·          Breathing assistance
·          Intravenous fluids
·          Anti inflammatory drugs — corticosteroids , help to reduce swelling and pressure within the skull
·          Anticonvulsant — such as phenytoin to stop or prevent seizures.


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BSN Notes: Neurology- Encephalitis
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