Encephalitis ☺️

Question 1

Pathophysiology

Presentation

Answer 1

Inflammation of brain

• fever, headache
• reduced consciousness, coma
• seizure
• agitation
• focal neuro

Question 2

Cause

-describe the pattern of infection

Answer 2

Direct infection - viral/bacterial most common
Some viruses have an increased tendency to infect nervous system

Neurotropic -affinity for specific neurons
-poliomyelitis - motor neurones
-VZV - peripheral sensory
-rabies - brainstem
Neurohistiopathic -no preference for specific neurones
-HSV

AI

Question 3

Investigations

Answer 3

Gold standard - CSF PCR - identify causative virus/bacterium
-CSF culture

Blood, throat, stool, urine culture

Head CT - rule out other causes
EEG - lateralised periodic discharge in HSE

Question 4

Management for

• viruses in general
• HSV
• HIV
• JC virus

Answer 4

No effective treatment for most viruses

HSE - aciclovir
HIV - HAART
JC - reverse immunosuppression, HAART in HIV patients

Question 5

Presentation of herpes simplex encephalitis

Answer 5

Typical encephalitis symptoms - Fever, headache, agitation, seizures, vomiting

Focal features - temporal lobe signs

• Wernicke’s aphasia
• prosopagnosia
• auditory agnosia
• sup hom quadrantopia

Cold sores