Encephelitis

Question 1

Define encephelitis

Answer 1

Inflammation of the brain parenchyma (neurons and glial cells) associated with neurological signs (not meninges)
Not necessarily infectious

Question 2

Aetiology and risk factors for encephelitis

Answer 2

only 50% are have a cause found
Usually viruses-VZV, Japanese, B encephalitis, Rabies, Mumps, West nile, HIV, Arboroviruses, HSV

Non viral-bacterial meningitis, TB, Malaria, typhus
few fungal and parasites

prions

risk factors:
higher in under 1y/o and over 65
HIV
Immunocompromise
post infection

Question 3

Epidemology of encephelitis

Answer 3

2500 in England per year in hospital but real number may be higher

Question 4

Signs and symptoms of encephalitis

Answer 4

Often suspected with ODD behaviour (neurological) + sign of infection (rash, lymphadenopathy)

can expect similar to meningitis-neck pain, rash, fever

So neuro-
Altered mental state, focal neurology (ataxia, hemiplegia, cranial nerve and ANYTHING ELSE), lower consciousness , SEIZURES

Infection-rash, fever, neck pain, cold sores, conjutivitis

other signs are those specifc to causing organisms

Question 5

Investigations of encephalitis

Answer 5

FBC-high WBC
Blood cultures,
Serum for viral PCR (+throat swab and MSU)
Check IgM, malaria film

Contrast CT-

Lumbar punction-high CSF proteins and lympho, low glucose. send for viral PCR

EEG-diffuse abnormalities to confirm a diagnosis

treat by supporting and acyclovir, and symptomatic treatment