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Post-Encephalitic Syndrome

Postencephalitic Syndrome


Presentation

  • Following this episode, he presented a severe parkinsonian syndrome which was associated, after a few years, with an axial dystonia and stereotyped involuntary movements of the upper limbs.[ncbi.nlm.nih.gov]
  • Mental deterioration over time may also be seen, especially in patient presenting later in adolescence. Pathologic features are similar to viral encephalitis, with lymphocytes around round cells and diffuse proliferation of microglia.[radiopaedia.org]
  • In 1916, von Economo first described encephalitis lethargica (EL), a CNS disorder presenting with pharyngitis followed by sleep disorder, basal ganglia signs (particularly parkinsonism) and neuropsychiatric sequelae.[ndcn.ox.ac.uk]
  • Encephalitis lethargica sufferers presented an unprecedented combination of neurologic and psychiatric symptoms – including previously puzzling phenomena primarily associated with schizophrenia and hysteria, as well as behavioral changes and attention[books.google.es]
Malaise
  • That said, they may include altered sleep patterns, altered eating habits, irritability, learning problems, and a general sense of malaise or apathy that won't go away.[gomentor.com]
  • A three day prodrome of headaches, malaise, nausea and vomiting was followed by fever and focal motor seizures involving the left side of the face and the left arm. Lumbar puncture showed 122 WBCs (80% lymphocytes) and a protein of 31 mg/dl.[pediatricneurologybriefs.com]
  • Someone can keep as sequelae of these serious infections : epilepsy by scar tissue, spasticity, fatigue altered sleep pattern malaise memory problems altered eating patterns irritability and apathy ( also called a postencefalitic syndrome ) changes in[braininjury-explanation.com]
  • But for Henning, being able to know what’s causing his malaise will go a long way to giving him peace of mind.[pbs.org]
Yawning
  • By Richard Klasco, M.D Photo Credit Ask Well Photo Credit Why Do We Yawn? Reading about yawning makes people yawn. You are probably yawning right now. By Roni Caryn Rabin Latest Search Latest Articles Search Articles 13844 results for sorted by[nytimes.com]
Nausea
  • A three day prodrome of headaches, malaise, nausea and vomiting was followed by fever and focal motor seizures involving the left side of the face and the left arm. Lumbar puncture showed 122 WBCs (80% lymphocytes) and a protein of 31 mg/dl.[pediatricneurologybriefs.com]
  • 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]
  • 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]
  • More serious cases In more serious cases, the person may experience very severe headaches, nausea, vomiting, confusion, disorientation, memory loss, speech problems, hearing problems, hallucinations, as well as seizures and possibly coma.[medicalnewstoday.com]
Bulimia
  • Some of the other symptoms of this disorder include bulimia, emotional placidity, hyperorality (sticking inappropriate items in the mouth), hypermetamorphosis (compulsive fascination with nearby objects), and even hypersexuality.[gomentor.com]
Hypertension
  • She found that those most likely to develop severe infections were older adults with hypertension and that even those with the most severe infections seemed to recover within a few weeks.[pbs.org]
Diplopia
  • After a period of general unease, the victim presented double vision (diplopia), deep somnolence, and sometimes mild fever.[theconversation.com]
Hearing Problem
  • More serious cases In more serious cases, the person may experience very severe headaches, nausea, vomiting, confusion, disorientation, memory loss, speech problems, hearing problems, hallucinations, as well as seizures and possibly coma.[medicalnewstoday.com]
Behavior Disorder
  • […] and behavioral disorders due to known physiological condition F07.9 Unspecified personality and behavioral disorder due to known physiological condition F09 Unspecified mental disorder due to known physiological condition F10 Alcohol related disorders[icd10data.com]
  • Convert to ICD-10-CM : 310.89 converts approximately to: 2015/16 ICD-10-CM F07.89 Other personality and behavioral disorders due to known physiological condition 310.89 Excludes memory loss of unknown cause ( 780.93 ) Applies To Mild memory disturbance[icd9data.com]
Facial Grimacing
  • The tics were characterized by facial grimacing, head twitching, and shoulder shrugging plus eye rolling, facial contorsions, jumping, touching objects and body parts and making obscene gestures.[pediatricneurologybriefs.com]
Irritability
  • That said, they may include altered sleep patterns, altered eating habits, irritability, learning problems, and a general sense of malaise or apathy that won't go away.[gomentor.com]
  • Symptoms of postencephalistic syndrome may include : A general malaise or sense of apathy Irritability, irritation Learning difficulties and struggling to hold the scholar Altered sleeping and eating Change in sexual behavior Reduced social assessment[braininjury-explanation.com]
  • If the neck is stiff, caused by irritation of the meninges (membranes that cover the brain and spinal cord), the doctor may consider a diagnosis of meningitis or meningoencephalitis.[medicalnewstoday.com]
  • Younger children, between 5 and 10 years old, might merely irritate with their clinginess; their impaired concentration; their incessant restlessness and need for noise; and their lack of consideration for others – not unlike current attention deficit[theconversation.com]
Personality Change
  • 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]
  • change due to known physiological condition 2016 2017 2018 2019 Billable/Specific Code Applicable To Frontal lobe syndrome Limbic epilepsy personality syndrome Lobotomy syndrome Organic personality disorder Organic pseudopsychopathic personality Organic[icd10data.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]
  • At times, a person infected with EL may see behavioral and personality changes, and sometimes they can become psychotic.[socrates8181nc.tripod.com]
  • Because AE can affect different part of the brain, people with AE can have poor memory or cognition, develop seizures or movement abnormalities, or have changes in their mood or behavior with hallucinations or personality changes.[aealliance.org]
Aphasia
  • Overview Quick Reference An organic mental disorder following recovery from viral or bacterial encephalitis, characterized by non-specific and variable behavioural change, including paralysis, deafness, amnesia, aphasia, apraxia, or acalculia.[oxfordreference.com]
  • 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]
Rabies
  • […] inflamed bacterial or fungal infections – these are much rarer causes of encephalitis than viral infections Some types of encephalitis are spread by mosquitoes (such as Japanese encephalitis ), ticks (such as tick-borne encephalitis ) and mammals (such as rabies[nhs.uk]
  • Japanese encephalitis is spread by mosquitoes Tick-borne encephalitis is spread by ticks Rabies can be spread through a bite from a mammal There is also primary or secondary encephalitis.[medicalnewstoday.com]
Lethargy
  • The patients had remarkable similarity to the historical descriptions of EL: sleep disorder (somnolence, sleep inversion or insomnia), lethargy, parkinsonism, dyskinesias and neuropsychiatric symptoms.[ndcn.ox.ac.uk]
  • Symptoms can range from listlessness, lethargy to coma. Coordination disorders and difficulty walking to paralysis ( severe ) cognitive symptoms including memory loss and epilepsy. ( standalone ) Creutzfeld Jacob, a type of protein caused by prions.[braininjury-explanation.com]

Workup

  • Workup should include a thorough history and physical exam to determine if the clinical course could be consistent with AE.[aealliance.org]

Treatment

  • Treatment for Postencephalitic Syndrome Treatments for postencephalitic syndrome will vary depending on a number of issues including the exact cause of postencephalitic syndrome, but on GoMentor.com you can find therapists and psychologists who are skilled[gomentor.com]
  • I'm curious to know if there are any others out there like me, who had encephalitis/suffered from PES and subsequently were diagnosed with a serious illness that perhaps required invasive treatment.[inspire.com]
  • Treatment with L-dopa suppressed all akinetic, dystonic and dyskinetic symptoms. At age of 40 years, all the akinetic, dystonic and dyskinetic symptoms reappeared after drug withdrawal.[ncbi.nlm.nih.gov]
  • Treatments for encephalitis Encephalitis needs to be treated in a hospital. The earlier treatment is started, the more successful it's likely to be.[nhs.uk]

Prognosis

  • […] cortical atrophy with ex-vacuo ventricular dilatation 15 T2: hyperintense signal areas in the affected hemisphere 15 DWI/ADC: restricted diffusion may be seen in altered signal areas 15 T1 C (Gd): no significant post-contrast enhancement 15 Treatment and prognosis[radiopaedia.org]
  • In Nepal, it is not uncommon for patients who are deemed to have a very bad prognosis to be taken by their relatives to die at home.[journals.plos.org]

Etiology

  • […] and Neurodevelopmental disorders F01-F09 2019 ICD-10-CM Range F01-F09 Mental disorders due to known physiological conditions Note This block comprises a range of mental disorders grouped together on the basis of their having in common a demonstrable etiology[icd10data.com]
  • A study from Kushinagar in 2011-2012 found that record keeping, test results and vaccination history were so poor that “inferences about the epidemiology and etiology of AES could not be made”.(13) One of the conclusions that can be drawn from the various[sphcm.med.unsw.edu.au]

Epidemiology

  • Epidemiologic and clinical data were prospectively recorded on the basis of the patients' medical charts. Epidemiologic data included gender, age, ethnic group, place of residence, travel history, and JE vaccination history.[journals.plos.org]
  • Epidemiology of Japanese encephalitis in context with Indian scenario. (abs.) J Indian Med Assoc. 2008 Oct;106(10):660-3. (4) Tiwari, S et al.[sphcm.med.unsw.edu.au]
  • Epidemiology and estimated population burden of selected autoimmune diseases in the United States. Clin Immunol Immunopathol 1997;84:223-43.[nnjournal.net]
Sex distribution
Age distribution

Pathophysiology

  • His main research interest is in movement disorders, specifically the merging of clinical, electrophysiological and imaging methods to provide insights into the pathophysiology of conditions like dystonia and Parkinson's disease.[books.google.com]
  • NMDA receptor function, neuroplasticity, and the pathophysiology of schizophrenia. Int Rev Neurobiol 2004;59:491-515. DOI 34. Dalmau J, Gleichman AJ, Hughes EG, Rossi JE, Peng X, Lai M, Dessain SK, Rosenfeld MR, Balice-Gordon R, Lynch DR.[nnjournal.net]

Prevention

  • Preventing encephalitis It's not always possible to prevent encephalitis, but some of the infections that cause it can be prevented with vaccinations.[nhs.uk]
  • Collaborative Meta-Analysis of Randomised Trials of Antiplatelet Therapy for Prevention of Death, Myocardial Infarction, and Stroke in High Risk Patients. ‎[books.google.es]
  • 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]
  • Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions.[wwwnc.cdc.gov]
  • “West Nile virus is a preventable disease and although the overall risk for developing lingering and ongoing problems is relatively small, it does occur and you don’t want to take that chance,” Sejvar said. – by Kirsten H.[healio.com]

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