Group 2

z
ENCEPHALITI
S
z
ENCEPHALITIS
Encephalitis is inflammation of the brain.
There are several causes, but the most
common is a viral infection.
Encephalitis often causes only mild flu-like
signs and symptoms such as a fever or
headache or no symptoms at all. Sometimes
the flu-like symptoms are more severe.
Encephalitis can also cause confused
thinking, seizures, or problems with movement
or with senses such as sight or hearing.
In some cases, encephalitis can be life-
threatening. Timely diagnosis and treatment
are important because it's difficult to predict
how encephalitis will affect each individual.
z
CAUSES
The exact cause of encephalitis is often unknown. But COMMON VIRAL CAUSES
when a cause is known, the most common is a viral
 The viruses that can cause Encephalitis include:
infection. Bacterial infections and noninfectious
inflammatory conditions also can cause encephalitis.  Herpes simplex virus (HSV)
There are two main types of encephalitis:  Other herpes viruses
 Primary encephalitis. This condition occurs  Enteroviruses
when a virus or other agent directly infects the
brain. The infection may be concentrated in one  Mosquito-borne viruses
area or widespread. A primary infection may be a
 Tick-borne viruses
reactivation of a virus that had been inactive after
a previous illness.  Rabies viruses
 Secondary encephalitis. This condition results  Childhood infections
from a faulty immune system reaction to an
infection elsewhere in the body. Instead of
attacking only the cells causing the infection, the
immune system also mistakenly attacks healthy
cells in the brain. Also known as post-infection
encephalitis, secondary encephalitis often occurs
two to three weeks after the initial infection.
z
CAUSATIVE AGENTS
Viruses are the most common cause of infectious encephalitis:

 human herpes viruses: herpes simplex type I, herpes simplex type II, varicella-zoster virus, Epstein-Barr
virus, cytomegalovirus

 rash-causing viruses: mumps, measles, rubella

 throat and chest viruses: flu, enteroviruses

 gut viruses: enteroviruses, echo virus

 insect-borne viruses: Japanese encephalitis virus, West Nile virus

 tick-borne viruses: tick-borne encephalitis virus

Bacteria, fungus and parasites can cause infectious encephalitis more rarely:

 bacteria: mycoplasma, meningococcal, pneumococcal, listeria

 fungi: histoplasma, cryptococcus, candida

 parasites: malaria, toxoplasma

z
PATHOGENESIS

 Diffuse of cerebral edema, congestion and hemorrhage.

 Necrosis and degeneration of neurons

 Meningeal congestion with mononuclear infiltration, perivascular tissue necrosis

and myelin breakdown

 Glial proliferation

 Demyelination, vascular and perivascular destruction and cerebral cortical

involvement

 In case of rabies and herpes simplex infection, specific inclusions are identified.
z
INCUBATION PERIOD

In persons who develop symptoms, the incubation period (time from infection until illness) is
typically 5-15 days. Initial symptoms often include fever, headache, and vomiting. Mental status
changes, neurologic symptoms, weakness, and movement disorders might develop over the
next few days.

Among patients who develop encephalitis, 20% – 30% die.

Although some symptoms improve after the acute illness, 30%-50% of survivors continue to
have neurologic, cognitive, or psychiatric symptoms.
z
MODES OF TRANSMISSION

Viruses spread by different means, and some are more infectious than others. Some of the
modes of viral transmission include:

 coughs or sneezes from an infected person that release airborne viruses, which are then
inhaled by others

 infected insects (such as mosquitoes or ticks) and animals, which can transfer some
viruses directly into the bloodstream via their bite

 eating contaminated food or drink

 the transfer of some viruses can occur through touching an infected person

 there is evidence to suggest that some cases of viral encephalitis are caused by a dormant
viral infection (such as herpes simplex virus) becoming active again .
 Most people with viral encephalitis have mild flu-like symptoms,
z such as:

 Headache

 Fever
CLINICAL  Aches in muscles or joints
MANIFESTATION
 Fatigue or weakness
S
In infants and young children, signs and symptoms might also
include:

 Bulging in the soft spots of an infant's skull

 Nausea and vomiting

 Body stiffness

 Poor feeding or not waking for a feeding

 Irritability
z
CLINICAL MANIFESTATIONS
Sometimes the signs and symptoms are more severe, and might include:

 Confusion, agitation or hallucinations

 Seizures

 Loss of sensation or paralysis in certain areas of the face or body

 Muscle weakness

 Problems with speech or hearing

 Loss of consciousness (including coma)

z
TREATMENT
Treatment for mild encephalitis usually consists of:

 Bed rest

 Plenty of fluids

 Anti-inflammatory drugs — such as acetaminophen, ibuprofen and naproxen sodium to relieve headaches
and fevers

SUPPORTIVE CARE

People who are hospitalized with severe encephalitis might need:

 Breathing assistance, as well as careful monitoring of breathing and heart function

 Intravenous fluids to ensure proper hydration and levels of essential minerals

 Anti-inflammatory drugs, such as corticosteroids, to reduce swelling and pressure within the skull

 Anticonvulsant medications, such as phenytoin (Dilantin), to stop or prevent seizures

z
TREATMENT

FOLLOW-UP THERAPY

If you experience complications of encephalitis, you might need additional therapy, such as:

 Physical therapy to improve strength, flexibility, balance, motor coordination and mobility

 Occupational therapy to develop everyday skills and to use adaptive products that help
with everyday activities

 Speech therapy to relearn muscle control and coordination to produce speech

 Psychotherapy to learn coping strategies and new behavioral skills to improve mood
disorders or address personality changes