Encephalitis is an acute inflammation of the brain.

Two forms of the disease occur: Primary encephalitis: Infection begins in the brain and/or spinal cord. This form is more serious, but less common. Secondary encephalitis: Infection begins in one part of the body and then invades the brain and/or spinal cord. This form is more common and usually less severe than primary encephalitis. Etiology: Most often caused by a viral infection, but it can also be caused by a bacterial or parasitic infection. Risk factors: Primary encephalitis may occur any time of the year. Secondary encephalitis is more common during the warm summer months. Outdoor activities, weakened immune system, and young or old age increase risk. Precipitating factors: Persons outside during warm summer months, those that have not been immunized against chicken pox, measles, mumps, or rubella, individuals receiving cancer treatment, and individuals that have had an organ donation are most susceptible. Signs and Symptoms: Headache Fever Lethargy, irritability, and muscular weakness Altered mental status Motor or sensory deficits Speech abnormalities Nausea and vomiting Stiff neck Ataxic gate Tremor or convulsions Confusion/sleepiness Bulging fontanel Milder cases may not have any S&S of the disease Diagnosis: Most common diagnostic tools are the spinal tap to assess cerebrospinal fluid, EEG to assess brain wave activity, and CT scan or MRI to assess for edema or bleeding in the brain. A CT scan or MRI may be done before spinal tap to assess for increased intracranial pressure. Blood tests to assess for an infectious process and test for West Nile virus may also be done. Treatment: Treatment depends upon type of encephalitis. Antiviral medication is only given in severe cases of viral encephalitis or for herpes encephalitis. Treatment is aimed at symptomatic relief and treating disease process. Prevention is the best cure. Drug therapy Antiviralacyclovir (Zovirax), ganciclovir (Cytovene), and vidarabine (Vira-A) to treat infection caused by herpes simplex virus. Diureticsmannitol (Osmitrol) to decrease cerebral edema. Corticosteroidsdexamethasone (Decadron) to decrease edema and inflammation of the brain and spinal cord. Antileptics used to treat or prevent seizures. Antibiotics may be prescribed for underlying bacterial infection. Sedatives to decrease irritability and restlessness.

Nursing Process Elements Supportive therapy and prevention of secondary infection are treatment goals. Provide airway management and respiratory support. Assess neurological status and for S&S of increasing intracranial pressure. Notify physician immediately if S&S for occur. Provide intravenous fluids for administration of medication. Provide pain medication as needed for headache. Monitor vital signs and give acetaminophen (Tylenol) for fever as directed. Assist client with ambulation and activities of daily living as needed. Allow client time to answer and ask questions. If client has memory deficits, repeat teaching information as indicated. Assess need for physical, occupational, and/or speech therapy and refer as needed. Keep room quiet and allow for frequent rest periods throughout the day. Increase fluids and offer nutritional supplements throughout the day. Teach medication administration techniques for home therapy.