Encephalitis Overview and Classification

Encephalitis Overview

• Encephalitis is brain inflammation, often caused by viral infection.
• It's potentially life-threatening and can lead to permanent brain damage or death.

Etiology and Classification

• Primary Encephalitis: Caused by viruses attacking the central nervous system (CNS).
  • Two types:
    • Neurotrophic viruses (type A) attack nerve cells.
    • Pantropic viruses (type B) attack neurons.
• Secondary Encephalitis: Caused by viruses, bacteria, or parasites attacking brain tissue.

Prognosis

• Prognosis varies based on patient age (very young and very old are at higher risk) and the specific causative virus.

Meningoencephalitis

• When encephalitis occurs alongside meningitis, it's called meningoencephalitis.
• This can result from a direct infection or a consequence of a previous condition.

Clinical Presentation (Adults)

• Common symptoms: headache, confusion, fever, drowsiness, fatigue, seizures/convulsions, tremors, stroke, hallucinations, and memory problems
• Cranial nerve palsies, ataxia, dysarthria, and dysphasia are also potential symptoms.

Clinical Presentation (Infants)

• Common symptoms: irritability, poor appetite, and fever.

Complications

• Possible complications: impairment in intelligence, mood/behavior changes, residual neurological deficits, extrapyramidal symptoms, hyponatremia, encephalopathy, mononeuropathy, and flaccid paralysis.

Diagnostic Procedures

• Magnetic Resonance Imaging (MRI): Used to detect brain inflammation.
• Electroencephalography (EEG): Monitors brain electrical activity.
• Lumbar puncture (spinal tap): Examines cerebrospinal fluid.
• Urine analysis: Assists in diagnosis.
• Blood tests: Aid in diagnosis.

Medical Management (Mild Encephalitis)

• Bed rest: Crucial for recovery.
• Plenty of fluids: Essential for hydration.
• Anti-inflammatory medications: Like acetaminophen, ibuprofen, or naproxen, to relieve headaches and fever.

Medical Management (Severe Encephalitis)

• Supportive care: Breathing assistance, vigilant monitoring of breathing and heart function, and intravenous fluids to maintain hydration and electrolyte balance.
• Anti-inflammatory drugs (e.g., corticosteroids): Reduce swelling and pressure in the skull.
• Anticonvulsant medications (e.g., phenytoin): Prevent or stop seizures.

Rehabilitation

• Holistic approach addressing physical, cognitive, behavioral, emotional, and medical needs of patients and families.
• Services often include:
  • Physical therapy: Improving strength, flexibility, balance, motor coordination, and mobility.
  • Occupational therapy: Developing daily living skills and using adaptive tools.
  • Speech therapy: Learning to speak again.
  • Psychotherapy: Developing coping strategies and addressing mood or personality disorders.