Presentation
The authors will publish findings from this review in a peer-reviewed scientific journal (electronic and in-print) and present the results at national and international conferences. TRIAL REGISTRATION NUMBER: CRD42015029217. [ncbi.nlm.nih.gov]
Table 1: Diagnostic Criteria for Encephalitis and Encephalopathy of Presumed Infectious or Autoimmune Aetiology (extracted from Venkatesan et al. [2] ) Major Criterion (required): Patients presenting to medical attention with altered mental status (defined [clinmedjournals.org]
It should be remembered that these are syndromically defined diseases at present. [jnnp.bmj.com]
The case presented here contributes to the delineation of the approach to a patient profile with a similar clinical presentation and evolution to those presented in the literature [ 6 – 11 ]. [virologyj.biomedcentral.com]
CNS infection can present as infection of the subarachnoid space, as in meningitis, or as infection of the parenchyma, as in encephalitis, myelitis or abscess. [clinicaladvisor.com]
Entire Body System
- Pain
Initial symptoms usually include high temperature, headache and joint pain but as the infection progresses, more dangerous symptoms may start to develop and include the following: Related Stories CDC Health Alert Network provides recommendations to manage [news-medical.net]
Case presentation A 26-year-old immunocompetent male presented with dizziness, blurred vision, a 3-day history of fever, frontal headache, cervical and lumbar pain, and vomiting during the last 24 h. [virologyj.biomedcentral.com]
These treatments may include: rest pain killers corticosteroids (to reduce brain inflammation) mechanical ventilation (to help with breathing) lukewarm sponge baths anticonvulsants (to prevent or stop seizures) sedatives (for restlessness, aggressiveness [healthline.com]
General medical care will include close monitoring and pain relief drugs for headaches. Fever (high temperature) will be reduced using electric fans, sponging with lukewarm water, or medication. [brainandspine.org.uk]
These viruses include the poliovirus and the coxsackievirus, which usually cause an illness with flu-like symptoms, eye inflammation and abdominal pain. Mosquito-borne viruses. These viruses can cause infections such as West Nile, La Crosse, St. [mayoclinic.org]
- High Fever
The symptoms may include: high fever flu-like symptoms ( fever, headache ) severe headache photosensitivity nausea and vomiting obtundation / coma (muscle ) weakness eye muscle paralysis problems with vision / double vision epilepsy / seizures Some variations [braininjury-explanation.com]
Call your doctor if your child has a high fever, especially if he or she also has a childhood illness (like measles, mumps, or chickenpox) or is recovering from one. [kidshealth.org]
fever, headache, delayed physical response, and lethargy. [en.wikipedia.org]
It causes cyclic outbreaks and nosocomial infections every 2-3 years, characterized by high fever, irritability, and seizures. There is no CSF pleiocytosis, and PCR is required for diagnosis. [neuropathology-web.org]
Neurologic
- Headache
Symptoms The patient typically has a fever, headache, and photophobia (excessive sensitivity to light). There may also be general weakness and seizures. [medicalnewstoday.com]
Symptoms in mild cases of encephalitis usually include: fever headache poor appetite loss of energy a general sick feeling Serious cases of encephalitis can cause: a high fever severe headache nausea and vomiting stiff neck confusion personality changes [kidshealth.org]
The symptoms may include: high fever flu-like symptoms ( fever, headache ) severe headache photosensitivity nausea and vomiting obtundation / coma (muscle ) weakness eye muscle paralysis problems with vision / double vision epilepsy / seizures Some variations [braininjury-explanation.com]
When this infection is not very severe, the symptoms may be similar to those of other illnesses: Fever that is not very high Mild headache Low energy and a poor appetite Other symptoms include: Clumsiness, unsteady gait Confusion, disorientation Drowsiness [medlineplus.gov]
- Aphasia
Within a few days the patient gets severe symptoms like seizures, unconsciousness, hemiplegia, visual disturbances and aphasia. This leads to rapid referral from the GP to the emergency room. [braininjury-explanation.com]
Complications may include: Loss of memory - especially among those who had herpes simplex virus encephalitis Behavioral or personality changes - such as mood swings, bouts of frustration and anger, and anxiety Epilepsy Aphasia - language and speech problems [medicalnewstoday.com]
The utilization of donepezil is helpful for short-term memory loss and aphasia commonly seen in WNL, PML and HHV-6. [now.aapmr.org]
Neurological examination may reveal focal features such as fronto-temporal signs, aphasia, personality change, and focal seizures which are characteristic of HSE, but such focality may be minimal during acute viral encephalitis and may not be diagnostic [jnnp.bmj.com]
- Neck Stiffness
Other possible symptoms include photophobia, sensory changes and neck stiffness. Epilepsy, focal neurological signs and cognitive impairment may develop. [patient.info]
Less common symptoms The individual may also experience nuchal rigidity (neck stiffness), which can lead to a misdiagnosis of meningitis. There may be stiffness of the limbs, slow movements, and clumsiness. [medicalnewstoday.com]
[…] several hours or a day: headache fever (high body temperature) general feeling of being unwell After the initial symptoms, the headache can become severe and people can also experience: nausea (feeling sick) and vomiting (being sick) mild to moderate neck [brainandspine.org.uk]
- Febrile Seizures
Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) is reported only in East Asian infants, characterized by a febrile seizure (usually >30 min) as the initial neurological symptom on day 1, followed by secondary seizures at [ncbi.nlm.nih.gov]
Workup
Should there be a standardised approach to the diagnostic workup of suspected adult encephalitis? A case series from Australia. BMC Infect Dis. 2010 Dec 15;10:353. PMC3018438. Irani SR, Vincent A. [lifeinthefastlane.com]
Finding the causative agent in infectious encephalitis is a daunting task; despite extensive diagnostic workup 1/3 to 2/3 of the cases have an unknown etiology by the time of admission to rehabilitation. 1 Etiological agents differ between immunocompetent [now.aapmr.org]
Treatment
The interest of a diagnosis of encephalitis for which there is no specific treatment is also to discontinue any empirical treatments initially prescribed. Physicians must consider and search for autoimmune encephalitis. [ncbi.nlm.nih.gov]
Anti-infective agents Choice of treatment varies widely based on suspected or confirmed etiologic agent. Please see Table II for treatment options. Table II. Treatment options and adjunctive therapies for specific organisms. [infectiousdiseaseadvisor.com]
Disease monitoring, follow-up and disposition Expected response to treatment With appropriate treatment: CSF culture and gram stain will become negative in 24-48 hours, glucose will normalize in 72 hrs. [clinicaladvisor.com]
Treatments for encephalitis Encephalitis needs to be treated in a hospital. The earlier treatment is started, the more successful it's likely to be. [nhsdirect.wales.nhs.uk]
Prognosis
Prognosis Encephalitis causes high rates of illness and death. [ 1 ] The prognosis depends on the age of the patient and the underlying aetiology. [patient.info]
In addition, even experienced physicians often are uncertain about the cause, appropriate therapy, and prognosis. [pedsinreview.aappublications.org]
Worse prognosis if: extremes of age ( 55y) comorbidities immunodeficiency virulent organism References and links LITFL Anti-NMDA Receptor Encephalitis (CCC) HSV encephalitis (CCC) Journal articles Armangue T, Leypoldt F, Dalmau J. [lifeinthefastlane.com]
The answers are relevant to prognosis and, more recently, selection of the correct therapeutic strategy. [jnnp.bmj.com]
[…] autoimmune, certain medication, unknown [2] Diagnostic method Based on symptoms, supported by blood tests, medical imaging, analysis of cerebrospinal fluid [2] Treatment Antiviral medication, anticonvulsants, corticosteroids, artificial respiration [1] Prognosis [en.wikipedia.org]
Etiology
etiology in 56 (34%) patients. [ncbi.nlm.nih.gov]
Among patients for whom etiology was confirmed/probable, the etiologic pathogen was potentially treatable for 48%. [wwwnc.cdc.gov]
Epidemiology
The epidemiology of encephalitis is constantly evolving. Epidemiological data may indicate the emergence and/or dissemination of new causative agents. [ncbi.nlm.nih.gov]
Epidemiology and Infection, Vol. 143, Issue. 15, p. 3300. CrossRef Google Scholar Venkatesan, Arun 2015. Epidemiology and outcomes of acute encephalitis. Current Opinion in Neurology, Vol. 28, Issue. 3, p. 277. [cambridge.org]
(Epidemiology of encephalitis cases from California 1998-2005.) Clinical guidelines Tunkel, AR, Glaser, CA, Bloch, KC, Sejvar, JJ, Marra, CM, Roos, KL, Hartman, BJ, Kaplan, SL, Scheld, WM, Whitley, RJ. [infectiousdiseaseadvisor.com]
“Acute Bacterial meningitis in Infants and Children: Epidemiology and Management”. Peaediatr Drugs. 2011. (Good review of antibiotic choices.) National Institute for Health and Clinical Excellence: Guidance. [clinicaladvisor.com]
Pathophysiology
Herpes Simplex Virus-1 Encephalitis in Adults: Pathophysiology, Diagnosis, and Management. Neurotherapeutics. 2016; 13(3): 493-508. PubMed George BP, Schneider EB, Venkatesan A. [arupconsult.com]
Its incidence in children was 0.2/100,000 – 0.4/100,000 in the published studies. 6 Patho-anatomy/physiology Pathophysiology of the disease depends on the infecting agent. [now.aapmr.org]
Clinical symptoms: Fever and headaches may persist for 7-10 days, Pathophysiology Invasion of the CNS via 5 steps: Colonization of the nasopharynx by adhesion to the mucosa. [clinicaladvisor.com]
[…] soon as the diagnosis is suspected Always consider epidemiological factors that may indicate an unusual cause of encephalitis (e.g. arboviruses and zoonoses), especially in Australia Encephalitis is commonly fatal or results in significant morbidity PATHOPHYSIOLOGY [lifeinthefastlane.com]
^ "Encephalitis: Practice Essentials, Background, Pathophysiology". 2018-08-07. Archived from the original on 2015-08-03. ^ Larner, A. J. (2013-05-02). Neuropsychological Neurology: The Neurocognitive Impairments of Neurological Disorders. [en.wikipedia.org]
Prevention
What can travelers do to prevent Japanese encephalitis? Travelers can protect themselves from JE by getting JE vaccine and preventing mosquito bites. [dartmouth-hitchcock.org]
How can encephalitis be prevented? The way to prevent encephalitis is to prevent the viral illness that can lead to a complication like encephalitis. [vdh.virginia.gov]
The dissemination and emergence of causative agents are fostered by environmental, social, and economical changes, but prevention programs (vaccination, vector controls) help reduce the incidence of other infectious diseases and associated encephalitis [ncbi.nlm.nih.gov]
How can encephalitis be prevented? Varicella, measles, mumps, and influenza can be prevented with vaccine. HIV encephalitis is decreased in patients on highly active antiretroviral therapy (HAART). [infectiousdiseaseadvisor.com]
Can Encephalitis Be Prevented? Encephalitis can't be prevented, but you can avoid the illnesses that may lead to it. Immunizations protect kids from many common childhood illnesses. So follow the immunization schedule recommended by your doctor. [kidshealth.org]