Encephalitis Flashcards

1
Q

def

A

inflammation of brain parenchyma

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2
Q

aetiology

A

most cases are due to viral infection

non-viral causes are rare

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3
Q

what are the viral causes of encephalitis

A
1 HSV 1+2 (most common in UK)
2 arboviruses
3 CMV (immunocompromised)
4 EBV
5 VZV
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4
Q

what are arboviruses transmitted by

A

mosquitoes

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5
Q

what are the non-viral causes of encephalitis

A
1 any bacterial meningitis
2 TB
3 malaria
4 legionella
5 aspergillosis
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6
Q

epi

A

10 per 100,000 PA in UK

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7
Q

history

A
subacute onset (hours to days) of:
1 headache
2 neck stiffness
3 photophobia (symptoms of meningism)
4 behavioural changes
5 drowsiness + confusion

associated with seizures + foreign travel + animal bite

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8
Q

examination

A

associated with decreased consciousness (plus deteriorating GCS), seizures, pyrexia
signs of meningism
signs of raised intracranial pressure

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9
Q

what are the signs of meningism

A

neck stiffness
photophobia
kernigs test positive

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10
Q

what is kernigs test and what does a positive result indicate

A

thigh flexed at the hip and knee at 90 degree angles
subsequent extension in the knee is painful (leading to resistance)

meningitis
SAH

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11
Q

what are the signs of raised intracranial pressure

A

HTN

bradycardia

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12
Q

investigations

A
1 bloods
-FBC (increased lymphocytes)
-glucose (compare with CSF glucose)
-viral serology
2 MRI/CT
-HSV produces characteristic bilateral oedema in temporal lobes
3 LP
-typically increased lymphocytes and protein, with decreased glucose
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13
Q

what are the risk factors for encephalitis

A

> 65yrs
animal/insect bites
foreight travel

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14
Q

management

A

aciclovir

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15
Q

why is blood glucose compared with csf glucose in encephalitis

A

discriminates between bacterial meningitis and viral menigitis
bacterial meningitis - low CSF glucose
viral meningitis - normal CSF glucose

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