encephalitis

Ingles 7°A

JONATHAN JESUS CIBRIAN CRUZ

Viruses reach the CNS via hematogenous or neuronal routes, with the
hematogenous route being the most common, resulting in alterations in the
permeability of the blood-brain barrier.

Encephalitis is the inflammation of the brain parenchyma, as it is the result of a

direct viral invasion, even acute disseminated encephalomyelitis is the
inflammation of the brain and spinal cord produced by a hypersensitivity reaction to
a virus or a foreign protein, both disorders therefore They are generally triggered
by a virus, the symptoms can be: fever, headache and altered mental status, which
are usually accompanied by seizures or focal neurological deficits. To diagnose
encephalitis, we will require analysis of the cerebrospinal fluid and neuroimaging.
Treatment is symptomatic and, for certain causes, includes antiviral agents.

Signs and symptoms

Symptoms of encephalitis include fever, headache, and altered mental status,

often accompanied by seizures and focal neurological deficits. A digestive or
respiratory prodrome may precede these symptoms. Typically, meningeal signs
are mild and less prominent than other manifestations. Sickness, especially
convulsive status epilepticus or coma, suggests severe brain inflammation and a
poor prognosis. Olfactory crises, which manifest as an aura of unpleasant odors
(rotten egg, burnt meat), indicate temporal lobe involvement and suggest HSV
encephalitis.

Pathophysiology

In acute encephalitis, inflammation and edema occur in infected areas throughout

the cerebral hemispheres, brainstem, cerebellum, and sometimes the spinal cord.
Petechial hemorrhages may occur in severe infections; direct viral invasion of the
brain usually damages neurons and sometimes produces inclusion bodies visible
under a microscope. Severe infection, especially encephalitis

Untreated HSV (herpes simplex virus) can cause hemorrhagic brain necrosis.
Acute disseminated encephalomyelitis is characterized by multifocal areas of
perivenous demyelination and the absence of virus in the brain.
Diagnosis

anamnesis

 Assess risk factors.

 Altered mental status ➜ characteristic indicator of encephalitis (HSV-1 in
temporal lobe).
 Meningeal S&S in meningoencephalitis.

physical exploration

 Fever and altered mental status (Frequency).

 Focuses ➜ aphasia, personality changes, ataxia and N paralysis.
 Cranial. Seizures generalized or focal.
 Motor disorders ➜ flavivirus (WNV or JEV). Rashes and signs of bites.

Treatment

Acyclovir

 Switch to Valacyclovir if adverse effects persist and when there is outpatient

transfusion.
 Adverse effects: Neuro and Nephrotoxicity.