Encephalitis

Question 1

What is encephalitis?

Answer 1

Viral infection of brain parenchyma

Question 2

What is the most common cause of encephalitis?

Answer 2

Herpes Simplex Virus-1 (95%)

Question 3

What are causes other than HSV-1 of encephalitis?

Answer 3

CMV
EBV
Toxoplasmosis
HIV

Question 4

What are risk factors for encephalitis?

Answer 4

Immunocompromised
Extremities of age

Question 5

What are symptoms of encephalitis?

Answer 5

Fever
Headache
Altered consciousness
Altered cognition
Unusual behaviour
Acute onset of focal seizures
Focal neurology

Question 6

What lobe is most commonly affected in encephalitis?

Answer 6

Temporal lobe (eg. aphasia - difficulty with language or speech)

Question 7

How do you diagnose encephalitis?

Answer 7

Lumbar puncture with CSF showing viremia and increase lymphocytes

Possibly viral PCR testing

MRI head shows unilateral encephalitis (normally temporal)

Period 2Hz firing in EEG

Question 8

How do you treat encephalitis?

Answer 8

Aciclovir
(antibiotic for HSV and VZV)

or if CMV, use Ganciclovir

Question 9

When should Aciclovir be given for encephalitis?

Answer 9

Started empirically in suspected encephalitis until results are available

Question 10

What are complications of encephalitis?

Answer 10

Chronic pain
Headaches
Seizures
Changes to memory and cognition
Learning disability
Fatigue
Change in personality or mood
Hormonal imbalance