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20-September-2008 10:08:30 - Encephalitis Encephalitis Classification and external resources ICD-10 A83.-A86., B94.1, G05. ICD-9 323 DiseasesDB 22543 eMedicine emerg/163 MeSH D004660 Encephalitis is an acute inflammation of the brain, commonly caused by a viral infection. It can be caused by a bacterial infection such as bacterial meningitis spreading directly to the brain primary encephalitis, or may be a complication of a current infectious disease like rabies or syphilis secondary encephalitis. Certain parasitic or protozoal infestations, such as toxoplasmosis, malaria, or primary amoebic meningoencephalitis, can also cause encephalitis in people with compromised immune systems. Lyme disease may also cause encephalitis. Bartonella henselae can also lead to this. Brain damage occurs as the inflamed brain pushes against the skull, and can lead to death. Contents 1 Symptoms 2 Etiology 3 Diagnosis 4 Treatment 5 Encephalitis lethargica 6 Herpes simplex encephalitis 7 Limbic system encephalitis 8 See also 9 References 10 External links Symptoms Patients with encephalitis suffer from fever, headache and photophobia with weakness and seizures also common. Less commonly, stiffness of the neck can occur with rare cases of patients also suffering from stiffness of the limbs, slowness in movement and clumsiness depending on which specific part of the brain is involved. The symptoms of encephalitis are caused by the brain's defense mechanisms activating to get rid of the infection. Etiology Encephalitis may be caused by a variety of afflictions. One such affliction is rabies. Encephalitis may also be caused by HIV. The major causes of encephalitis outbreaks all over the world are viruses like Japanese Encephalitis, West Nile, Chandipura virus, St. Louis Encephalitis, Equine Encephalitis, La Crosse encephalitis, Murray Valley encephalitis virus, California encephalitis virus, Tick-borne meningoencephalitis, Herpes simplex, Influenza A virus. Less common are e.g. RSSE Russian spring-summer encephalitis1 viruses. Diagnosis Adult patients with encephalitis present with acute onset of fever, headache, confusion, and sometimes seizures. Younger children or infants may present irritability, anorexia and fever. Neurological examinations usually reveal a drowsy or confused patient. Stiff neck, due to the irritation of the meninges covering the brain, indicates that the patient has either meningitis or meningeoncephalitis. Examination of the cerebrospinal fluid obtained by a lumbar puncture procedure usually reveals increased amounts of protein and white blood cells with normal glucose, though in a significant percentage of patients, the cerebrospinal fluid may be normal. CT scan often is not helpful, as cerebral abscess is uncommon. Cerebral abscess is more common in patients with meningitis than encephalitis. Bleeding is also uncommon except in patients with herpes simplex type 1 encephalitis. Magnetic resonance imaging offers better resolution. In patients with herpes simplex encephalitis, electroencephalograph may show sharp waves in one or both of the temporal lobes. Lumbar puncture procedure is performed only after the possibility of prominent brain swelling is excluded by a CT scan examination. Diagnosis is often made with detection of antibodies in the cerebrospinal fluid against a specific viral agent such as herpes simplex virus or by polymerase chain reaction that amplifies the RNA or DNA of the virus responsible such as varicella zoster virus. Treatment Treatment is usually symptomatic. Reliably tested specific antiviral agents are available only for a few viral agents e.g. acyclovir for herpes simplex virus and are used with limited success for most infection except herpes simplex encephalitis. In patients who are very sick, supportive treatment, such as mechanical ventilation, is equally important. Encephalitis lethargica Main article: Encephalitis lethargica Encephalitis lethargica is an atypical form of encephalitis which caused an epidemic from 1917 to 1928, resulting in millions of deaths worldwide. Those who survived sank into a semi-conscious state that lasted for decades until the Parkinsons drug L-dopa was used to revive those still alive in the late 1960s by Oliver Sacks. There have been only a small number of isolated cases in the years since, though in recent years a few patients have shown very similar symptoms. The cause is now thought to be either a bacterial agent or an autoimmune response following infection. Herpes simplex encephalitis Main article: Herpes simplex encephalitis Herpes simplex encephalitis is caused by the herpes simplex virus that manifests in oral cold sores or genital sores. When this triggers brain inflammation, which occurs in 10% of cases of encephalitis 2 cases per million people, half of all untreated patients die 1 case per million people. Brain damage, partial paralysis, seizures, hallucinations and an altered state of consciousness are all common symptoms. HSE can be passed from mother to child during birth in rare cases, where symptoms include lethargy, tremors, irritability, seizures and poor feeding in the first two weeks after birth. Limbic system encephalitis In a small number of cases, called limbic encephalitis, the pathogens responsible for encephalitis attack primarily the limbic system a collection of structures at the base of the brain responsible for basic autonomic functions. See also Granulomatous amoebic encephalitis Japanese Encephalitis St. Louis Encephalitis Equine Encephalitis Rasmussen's encephalitis La Crosse encephalitis Murray Valley encephalitis virus California encephalitis virus meningoencephalitis Tick-borne meningoencephalitis Herpes simplex Herpes zoster Awakenings Movie 1990 Powassan encephalitis References ^ Tick-Borne Encephalitis External links http://www.encephalitis.info resource providing evidence based support to people affected and professionals WHO: Encephalitis eMedicine-1 and eMedicine-2 Information on the causes, symptoms, and treatment options for Encephalitis. Encephalitis Global, Inc. Website offering information and support to encephalitis survivors, caregivers and loved ones. Encephalitis Global Inc. is a USA 501c3 public charity; annual FACES Encephalitis Conference information available at the website. A case study of a Limbic Encephalitis patient A website about Garrett Taylor a 2 year old who lost his life after a battle with encephalitis 1 v d e Pathology of the nervous system, primarily CNS G00-G47, 320-349 Inflammatory Meningitis Arachnoiditis - Encephalitis - Myelitis - Encephalomyelitis Acute disseminated - Tropical spastic paraparesis - Cavernous sinus thrombosis Systemic atrophies Huntington's disease - Spinocerebellar ataxia Friedreich's ataxia, Ataxia telangiectasia, Herary spastic paraplegia - Spinal muscular atrophy: Werdnig-Hoffman - Kugelberg-Welander - Fazio-Londe - MND ALS, PMA, PBP, PP, PLS Extrapyramidal and movement disorders Parkinson's disease - Neuroleptic malignant syndrome - Postencephalitic parkinsonism - Pantothenate kinase-associated neurodegeneration - Progressive supranuclear palsy - Striatonigral degeneration - Dystonia/Dyskinesia Spasmodic torticollis, Meige's, Blepharospasm - Essential tremor - Myoclonus - Lafora - Chorea Choreoathetosis - Restless legs - Stiff person Other degenerative/ demyelinating diseases dementia: Alzheimer's - Pick's - Dementia with Lewy bodies - Frontotemporal lobar degeneration mitochondrial disease: Leigh's demyelinating: Multiple sclerosis - Devic's - Central pontine myelinolysis - Transverse myelitis - Marchiafava-Bignami disease - CAMFAK syndrome - Alpers' Seizure/epilepsy Focal - Generalised - Status epilepticus - Myoclonic epilepsy Headache Migraine Familial hemiplegic - Cluster - Vascular - Tension Vascular Transient ischemic attack Amaurosis fugax, Transient global amnesia Cerebrovascular disease MCA, ACA, PCA, Foville's, Millard-Gubler, Lateral medullary, Weber's, Lacunar stroke Sleep disorders Insomnia - Hypersomnia - Sleep apnea Obstructive, Ondine's curse - Narcolepsy - Cataplexy - Kleine-Levin - Circadian rhythm sleep - Delayed sleep phase - Advanced sleep phase Intracranial hypertension Hydrocephalus Normal pressure - Idiopathic intracranial hypertension Other encephalopathy Brain herniation - Cerebral edema - Reye's Other spinal cord disease Syringomyelia - Syringobulbia - Morvan's syndrome - Spinal cord compression v d e Inflammation Acute Plasma derived mediators Bradykinin - complement C3, C5a, MAC - coagulation Factor XII, Plasmin, Thrombin Cell derived mediators preformed: Lysosome granules - vasoactive amines Histamine, Serotonin synthesized on demand: cytokines IFN-γ, IL-8, TNF-α, IL-1 - eicosanoids Leukotriene B4, Prostaglandins - Nitric oxide - Kinins Chronic Macrophage - Epithelioid cell - Giant cell - Granuloma Processes Traditional: Rubor - Calor - Tumor - Dolor - Functio laesa Modern: Acute-phase reaction - Chemotaxis - Fever - Pain - Vascular permeability - Vasodilation Specific types Cardiovascular Endocarditis - Myocarditis - Pericarditis - Vasculitis Arteritis, Phlebitis Digestive mouth Stomatitis, Gingivitis, Gingivostomatitis, Glossitis, Tonsillitis, Sialadenitis/Parotitis - tract Esophagitis, Gastritis, Gastroenteritis, Enteritis, Colitis, Enterocolitis, Duodenitis, Ileitis, Appendicitis, Proctitis - accessory Hepatitis, Cholangitis, Cholecystitis, Pancreatitis - Peritonitis Musc./int. Arthritis - Bursitis - Dermatitis Folliculitis - Dermatomyositis - Epicondylitis - Fasciitis - Fibrositis - Hidradenitis - Mastitis - Myositis - Osteitis - Synovitis - Tendinitis Nervous Encephalitis - Meningitis - Myelitis - Otitis - eye Blepharitis, Conjunctivitis, Dacryoadenitis, Iritis Respiratory upper Sinusitis, Rhinitis, Pharyngitis, Laryngitis - lower Tracheitis, Bronchitis, Bronchiolitis, Pneumonitis, Pleuritis Reproductive female: Cervicitis - Chorioamnionitis - Endometritis - Oophoritis - Salpingitis - Uveitis - Vaginitis - Vulvitis - Parametritis male: Epididymitis - Prostatitis - Orchitis newborn: Omphalitis Urinary Nephritis Glomerulonephritis, Pyelonephritis - Ureteritis - Cystitis - Urethritis Retrieved from http://en..org/wiki/Encephalitis Categories: Neurological disorders | Encephalitis | Infectious diseases | Inflammations | Greek loanwords Views Article Discussion this page History Personal tools Log in / create account Navigation Main page Contents Featured content Current events Random article Search Go Search Interaction Community portal Recent changes Contact Donate to Help Toolbox What links here Related changes Upload file Special pages Printable version Permanent link Cite this page Languages БългарÑ?ки Deutsch Español Esperanto Français हिनà¥?दी í•œêµì–´ Hrvatski Bahasa Indonesia Italiano Latina Magyar Nederlands 日本語 Polski Português РуÑ?Ñ?кий Simple English Suomi Svenska తెలà±?à°—à±? Tiếng Việt Türkçe ä¸æ–‡ This page was last modified on 9 August 2008, at 10:00
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