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Nervous System LO’s > Infections Of The Nervous System > Flashcards

Infections Of The Nervous System Flashcards

1
Q

What is meningitis

A

Inflammation/infection of meninges

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2
Q

What is encephalitis

A

Inflammation/infection of brain substance

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3
Q

What is myelitis

A

Inflammation/infection of spinal cord

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4
Q

What is the clinical presentation of encephalitis (6)

A
  • Flu-like prodrome (4-10days) (prodrome = symptom indicating onset of disease or illness)
  • progressive headache associated with fever
  • +/- meningism
  • Progressive cerebral dysfunction (confusion, abnormal behaviour, memory disturbance, depressed conscious level)
  • seizures
  • focal symptoms/signs
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5
Q

What are meningism symptoms (3)

A

Neck stiffness
Photophobia
Nausea + vomitting

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6
Q

What are focal symptoms/signs

A

Movement changes
Paralysis
Weakness
Loss of muscle control
Increased/loss of muscle tone
Involuntary movements (e.g. tremors)

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7
Q

What is difference in the onset of viral encephalitis and bacterial meningitis

A

Onset of viral encephalitis is slower and cerebral dysfunction is a more prominent feature

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8
Q

What is the priority when investigating encephalitis? What are the investigations

A

Priority is to exclude (and treat) infection

Blood cultures
imaging (CT and MRI)
Lumbar puncture
EEG

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9
Q

What is the most common cause of encephalitis in Europe

A

Herpes simplex

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10
Q

What is a brain abscess

A

Localised area of puss within the Brian

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11
Q

What is a Subdural empyema

A

Thin layer of pus between the dura and arachnoid membranes over the surface of the brain

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12
Q

What is the clinical presentation of cerebral abscesses (7)

A

Fever
Headache
Focal symptoms/signs
Seizures
Signs of raised ICP
Meningism may be present (especially with empyema)
Features of underlying source (e.g. dental, sinus, ear infection)

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13
Q

What are the common causes of brain abscesses and empyema

A

Penetrating head injury
Spread from adjacent infection (dental, sinusitis, otitis media)
Blood borne infection
Neurosurgical procedure

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14
Q

Which organism causes most brain abscesses

A

Streptococci (70%)

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15
Q

How are cerebral abscesses diagnosed (4)

A

Imagine (CT or MRI)
Investigate source
Blood cultures
Biopsy (drainage of pus)

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16
Q

How are brain abscesses managed

A

Surgical drainage if possible
Abx - high dose for penetration (penicillin or ceftiaxone to cover streps - Metronidazole for anaerobes)
(Culture and sensitivity test on aspirate provide a useful guide)
High mortality without appropriate treatment

17
Q

What is the clinical presentation of meningitis

A

Classic triad of: fever, stiff neck, altered mental status
History of progressive headache associated with fever and meningism
Cerebral dysfunction is common
LOOK FOR A PETECHIAL SKIN RASH (pinpoint round spots that appear on skin as result of bleeding - see photo)

18
Q

Which bacteria often cause meningitis

A

Neisseria meningitidis (meningococcus)
Streptococcus pneumoniae (pneumococcus)

19
Q

Which viruses often cause meningitis

A

Enteroviruses

20
Q

What is the investigation for meningitis (what is the priority)

A

Priority to exclude (and treat) infection
Blood cultures
Lumbar puncture (CSF culture/microscopy)
No need for imaging if no contraindications to lumbar puncture)

21
Q

What is the bacteria responsible for Lyme disease

A

Borrelia burgdorferi

22
Q

What is stage 1 of Lyme disease

A

Early localised infection (1-30days)
Characteristic expanding rash at the site of the tick bite (erythema migrans)
50% will have flu like symptoms in the first week

23
Q

What is stage 2 of Lyme disease

A

Early disseminated infection (weeks-months)
One or more organ systems become involved
- haematological or lymphatic spread
Muskuloskeletal and neurological involvement (PNS > CNS)

24
Q

What is stage 3 of Lyme disease

A

Chronic infection (months - years, occurring after latent period)
Neurological and muskuloskeletal involvement

IMPORTANT - LYME DOES NOT CAUSE CHRONIC FATIGUE SYNDROME

25
Q

What are the investigations for Lyme (4)

A

Serological tests
CSF lymphocytosis
MRI brai/spine (if CNS involved)
EMG (if PNS involved)

26
Q

What is the treatment for Lyme

A

Prolonged abx treatment
(IV ceftriaxone + oral doxycycline)

27
Q

What is a common prion disease

A

Creutzfeldt-Jakob disease (CJD)

28
Q

What is a prion

A

Transmissible proteinaceous particle (prion)

29
Q

What are the clinical features of sporadic CJD (6)

A

usually >60
Early behavioural abnormalities
Rapidly progressive dementia
Motor abnormalities
Cortical blindness
Seizures

30
Q

What motor abnormalities present in CJD

A

Cerebellar ataxia
Extrapyramidal (tremor, rigidity, bradykinesis, dystonia)
Pyramidal (weakness, spasticity, hyper-reflexia)

31
Q

What is the prognosis of CJD

A

Rapid progression
Death within 6mths

Nervous System LO’s (22 decks)

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