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Acute Care & Trauma > Encephalitis > Flashcards

Encephalitis Flashcards

1
Q

Define Encephalitis?

A

Inflammation of the brain parenchyma

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2
Q

What is encephalitis most commonly caused by?

A

Viral Infection

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3
Q

What are the Viral causes of encephalitis?

A 
Herpes Simplex Virus 
VZV
Mumps
Adenovirus
Coxsackie 
EBV 
HIV 
Japanese Encephalitis
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4
Q

What is the most common Viral cause of encephalitis in the UK?

A

Herpes Simplex Virus

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5
Q

What are some of the rarer non-viral causes of encephalitis?

A

Syphilis

Staphylococcus Aureus

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6
Q

What are the causes of encephalitis in immunocompromised patients?

A

CMV
Toxoplasmosis
Listeria

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7
Q

How is encephalitis somewhat autoimmune or paraneoplastic?

A

Associated with certain antibodies (e.g. anti-NMDA, anti-VGKC)

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8
Q

What is the epidemiology of encephalitis?

A

UK incidicence: 7.4/100,000

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9
Q

What are most cases of encephalitis?

A

Self-limiting and mild

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10
Q

What is the onset of encephalitis?

A

Subacute (hours to days)

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11
Q

What are the symptoms of encephalitis?

A 
Headache 
Fever 
Vomiting 
Neck Stiffness 
Photophobia 
Behavioural Changes 
Drowsiness 
Confusion 
History of seizures 
Focal neurological symptoms (e.g. dysphagia, hemiplegia)
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12
Q

What is important when dealing with encephalitis?

A

Obtain a detailed travel history

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13
Q

What are the signs of encephalitis on physical examinagtion?

A 
Reduced consciousness 
Deteriorating GCS (glasgow coma scale)
Seizures 
Pyrexia
Signs of Meningism 
Signs of raised ICP
Focal neurological sins
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14
Q

What are some of the signs of Meningism?

A

Neck Stiffness
Photophobia
Kernig’s Test postive

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15
Q

What are the signs of raised ICP?

A

Cushing’s Response: Hypertension + bradycardia + irregular breathing
Papilloedema

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16
Q

How can we use a MMSE?

A

Mini Mental State Exam (MMSE) can be used reveal cognitive / psychiatric disturbance

17
Q

What bloods could we do for encephalitis and what might they show?

A

FBC - high lymphocytes (indicates viral cause)
U & Es - SIADH may occur as a result of encephalitis
Glucose
Viral Serology
ABG

18
Q

Why might we do a MRI/CT and what might it show?

A

Exclude mass lesion

HSV causes oedema of the temporal lobe on MRI

19
Q

How can we use Lumbar Puncture for encephalitis?

A 
High Lymphocytes 
High Monocytes 
High protein
Glucose is usually normal
Viral PCR
20
Q

What might an EEG show in encephalitis?

A

Epileptiform activity

21
Q

What could we use rarely with encephalitis?

A

Brain Biopsy

Acute Care & Trauma (25 decks)

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