Encephelitis Flashcards
aetiology and risk factors of encephelitis
Inflammation of the brain- due to many causes
Mainly
VIRAL- most common- HSV,
Bacterial - N. Menigitides
Fungal - Cryptococcus
Parasite- Toxoplasmosis
Autoimmune/paraneoplastic- Anti-Hu, anti-NMDA, Prion
Presentation of encephelitis
Medical emergency-
Under 1 or over 65, (or 30 if AID)
Rapid Onset if infection
Slower if autoimmune (but faster than–dementia)
Often immunocompromised so check
major criteria- Altered brain status (Drowsy -> coma)
minor-
seizures
Cognitive changes- personality, labile, etc
fevers (depends on cause)
Focal neurology- aphasia, Hemiparesis, visual nerve changes, facial nerve changes, ataxia, tremors, etc)
Meningism common (neck stiff, photophobia,
Autoimmune take 3-4 month to develop, and has ++ psych sx
other sx–
rashes COMMON
Previous viral illness, travel
parotitis
Investigation of encephelitis
Any altered conscious status with focal neuro- think immediate LP (care of herniation-check with CT/MRI)
LP - same as meningitis results - viral (Lympho +), bacterial (sugar -, prot +, Leukocyte +, cloudy, Opening pressure +)
autoimmune- check ABs, Prot +
MRI is modality of choice
Management of encephalitis
A-E approach as emergency
admit to ITU and ISOLATE
CT head in case of LP contraindication
then LP
usually immediate start on Aciclovir and Abx (do LP first if possible)
rarely add steroids (controvertial), but do if ICP +
Non- infective-
rituximab, cylcophosphamide
