Encephalitis: Difference between revisions

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== Introduction  ==
== Introduction  ==
Encephalitis is a very severe [[Infectious Disease|infection]] caused by the inflammation of the [[Brain Anatomy|brain]] tissues. When encephalitis occur with meningitis, it is called meningoencephalitis. It is caused either as a direct infection or a sequela of a pre-existing condition. <ref name=":0">Kennedy PGE. Viral Encephalitis: Causes, Differential Diagnosis, and Management. Journal of Neurology, Neurosurgery & Psychiatry. 2004;75 (suppl 1): i10–i15</ref>
Encephalitis is an inflammation of the brain, usually caused by a viral infection. Although rare, it is potentially life-threatening, and may lead to permanent brain damage or death<ref>Brain foundation [https://brainfoundation.org.au/disorders/encephalitis/ Encephalitis] Available from:https://brainfoundation.org.au/disorders/encephalitis/ (last accessed 27.11.2020)</ref>.
 
Infectious encephalitis can be viral, bacterial, fungal, protozoal, or helminthic in etiology.
 
The etiology of many cases of encephalitis remains unknown despite extensive workup. Viruses are the most prevalent identified cause, accounting for about 70% of confirmed cases of encephalitis<ref>Said S, Kang M. [https://www.ncbi.nlm.nih.gov/books/NBK470162/ Viral Encephalitis].2017 Available from:https://www.ncbi.nlm.nih.gov/books/NBK470162/ (last accessed 27.11.2020)</ref>.
 
The prognosis for a person with encephalitis varies according to the age of the patient – with the very young and very old particularly at risk – and the particular virus that caused the disease.
 
When encephalitis occur with meningitis, it is called meningoencephalitis. It is caused either as a direct infection or a sequela of a pre-existing condition. <ref name=":0">Kennedy PGE. Viral Encephalitis: Causes, Differential Diagnosis, and Management. Journal of Neurology, Neurosurgery & Psychiatry. 2004;75 (suppl 1): i10–i15</ref>


== Causes ==
== Causes ==

Revision as of 07:00, 27 November 2020

Introduction[edit | edit source]

Encephalitis is an inflammation of the brain, usually caused by a viral infection. Although rare, it is potentially life-threatening, and may lead to permanent brain damage or death[1].

Infectious encephalitis can be viral, bacterial, fungal, protozoal, or helminthic in etiology.

The etiology of many cases of encephalitis remains unknown despite extensive workup. Viruses are the most prevalent identified cause, accounting for about 70% of confirmed cases of encephalitis[2].

The prognosis for a person with encephalitis varies according to the age of the patient – with the very young and very old particularly at risk – and the particular virus that caused the disease.

When encephalitis occur with meningitis, it is called meningoencephalitis. It is caused either as a direct infection or a sequela of a pre-existing condition. [3]

Causes[edit | edit source]

Encephalitis is caused by any of the following factors; [4]

  • Viral infection, e.g rabies virus, HSV, poliovirus, mealses virus, bunyavirus, reovirus, etc [5]
  • Bacterial infection, e.g mycoplasma, Lyme disease, Bartonella henselae, malaria, etc can result in encephalitis especially in immuno-compromised individuals.
  • Autoimmune disorders
  • Some types are of unknown aetiology

Clinical Presentation[edit | edit source]

An adult infected with the disease typically present with; [6]

  • Headache
  • Confusion
  • Fever
  • Drowsiness
  • Fatigue
  • Seizures or convulsions
  • Tremors
  • Stroke
  • Hallucinations
  • Memory problems

An infant may present with; [7]

  • Irritability
  • Poor appetite
  • Fever

Diagnostic Procedures[edit | edit source]

Encephalitis can be diagnosed using any of the following procedures; [3]

  • Magnetic Resonance Imaging (MRI) to detect the inflammation
  • Electroencephalography (EEG) to monitor the electrical activity of the brain
  • Lumbar puncture (spinal tap)
  • Urine analysis
  • Blood test

Medical Management[edit | edit source]

These may include; [3]

  1. Antiviral medications (for viral infection)
  2. Antibiotics (for bacterial infection)
  3. Steroids
  4. Sedatives
  5. Acetaminophen

Physiotherapy Management / Interventions[edit | edit source]

  1. Exercise therapy
  2. Gait rehabilitation
  3. Manual therapy
  4. Passive motion procedures

Differential Diagnosis[edit | edit source]

  1. Leptospirosis
  2. CNS vasculitis
  3. Meningoencephalitis
  4. Stroke
  5. Meningitis
  6. Subdural empyema
  7. Meningeal carcinomatosis

References[edit | edit source]

  1. ↑ Brain foundation Encephalitis Available from:https://brainfoundation.org.au/disorders/encephalitis/ (last accessed 27.11.2020)
  2. ↑ Said S, Kang M. Viral Encephalitis.2017 Available from:https://www.ncbi.nlm.nih.gov/books/NBK470162/ (last accessed 27.11.2020)
  3. ↑ 3.0 3.1 3.2 Kennedy PGE. Viral Encephalitis: Causes, Differential Diagnosis, and Management. Journal of Neurology, Neurosurgery & Psychiatry. 2004;75 (suppl 1): i10–i15
  4. ↑ Larner AJ. Neuropsychological Neurology: The Neurocognitive Impairments of Neurological Disorders. 2013. Cambridge University Press.
  5. ↑ Fisher DL, Defres S, Solomon T.  Measles-induced encephalitis. QJM. 2015; 108 (3): 177–182.
  6. ↑ Jmor F, Emsley HC, Fischer M. et al. The incidence of acute encephalitis syndrome in Western industrialised and tropical countries. Journal of Virology.2008; 5 (134): 134.
  7. ↑ Armangue T, Petit-Pedrol M, Dalmau J. Autoimmune Encephalitis in Children. Journal of child neurology. 2012; 27 (11): 1460–1469.
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