Encephalitis Flashcards
What is encephalitis?
inflammation of brain parenchyma a/w neurological dysfunction
Give 2 epidemiological facts about encephalitis
Most frequent + severe in children + elderly.
6/100,000/year
What is the most common cause of encephalitis? Give 5 examples
Viral infection
HSV1
VZV
EBV
Adenovirus
Coxsackie
What is the most common viral cause of encephalitis? Which lobes are usually affected?
HSV1
Temporal + inferior frontal lobes
List 4 non-viral causes of encephalitis
Bacterial infection: TB, Listeria, Syphilis
Fungal
Parasitic
AI
What may lead to encephalitis in immunocompromised patients?
CMV
Toxoplasmosis
Listeria
How do most patients with viral encephalitis present?
Sx of meningitis (fever, headache, neck stiffness, vomiting) followed by altered consciousness, convulsions, focal neurological signs, signs of raised ICP
List 5 symptoms of encephalitis
Fever
Headache
Altered mental state: somnolence, psychiatric manifestations
Meningismus
Vomiting
List 4 signs of encephalitis on examination
Reduced consciousness/ GCS
Seizures
Focal neurological signs: aphasia, ataxia, Babinski’s, brisk reflexes
MMSE may reveal cognitive/ psychiatric disturbance
What triad provides the clinical hallmark for acute encephalitis?
Fever
Headache
Altered mental status
What 3 signs of meningismus may present in encephalitis?
Headache
Photophobia
Neck stiffness
What investigations are performed in suspected encephalitis?
LP + CSF analysis
Neuroimaging
Electroencephalography
What would a lumbar puncture show in encephalitis?
High lymphocytes
Normal/ high protein
Normal glucose
Normal opening pressure
Viral PCR analysis for HSV, VZV + Enteroviruses
What is seen on neuroimaging in encephalitis?
Medial temporal + inferior frontal changes (e.g. petechial haemorrhages)
Normal in 1/3 of patients
MRI is preferred
CT r/o raised ICP, SOL, strokes, basilar fractures
Describe management of encephalitis
Aciclovir IV
Supportive care
