Condition- Encephalitis Flashcards
What is encephalitis?
Inflammation of the brain parenchyma
What is the most common cause of encephalitis? and list some other viral causes of it too
VIRAL INFECTION:
- HERPES SIMPLEX VIRUS
- VZV
- Mumps
- Adenovirus
- Coxsackie
- EBV
- HIV
- Japanese encephalitis
What is the most common bacterial cause of encephalitis? List some non-viral causes of encephalitis…
- Neisseria Meningitides- Meningoecephalitis
- Syphilis
- Staph aureus
List some of the causes of encephalitis in immunocompromised patients
Toxoplasma
Listeria
List some risk factors for developing encephalitis…
- Immunocompromised
- Viral infections
- Body fluid exposure
- Insect bites
- Location + Season (Japan, monsoon => Japanese Encephalitis)
List some of the presenting symptoms of Encephalitis…
- Subacute onset
- Infectious Signs: Fever, rash, lymphadenopathy
- Meningism signs: neck stifness, headache, vomiting
- Neuro/ Psych changes
- Seizures
- Neurological symptoms (dysphagia, hemiplegia etc)
- Memory impairement
- Behvioural changes- confusion
- TRAVEL HISTORY REQUIRED
List some of the signs of Encephalitis on examination
- Deteriorating GCS
- Seizures
- Signs of Infection: Pyrexia, lymphadenoapthy
- Signs of Meningism:
- Neck stiffness
- Photophobia
- Kernig’s positive
- Signs of raised ICP
- Cushing’s response: hypertension, bradycardia, irregular breathing
- Papilloedema
- Focal neurological signs
- MMSE=> cognitive distrubance
What is the Cushing’s response to RICP?
Hypertension
Low HR
irregular breathing
Which investigations would you order for someone with encephalitis?
- Bedside: HR, RR, BP, sats
- Bloods:
- Routine: FBC (High lymphocytes= viral cause), U&Es (SIADH may occur), Glucose
- Specific: Viral serology, ABG, toxoplasma IgM titre, Malaria film
- MRI/CT
- Exclude mass/lesion
- HSV causes temporal lobe oedema
- Meningeal enhancement= meningoencephalitis
- Lumbar Puncture
- High Lymphocytes
- High Monocytes
- High Protein
- Glucose= normal/ high
- Viral PCR- HSV
- EEG
- Brain biopsy (RARE)
Which drug is given to treat herpes encephalitis?
Aciclovir