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Postinfectious Encephalitis


Presentation

  • SUMMARY: Encephalitis and postinfectious encephalitis present as neurologic emergencies requiring prompt diagnosis and initiation of treatment.[ncbi.nlm.nih.gov]
  • More than 70 acute pediatric presentations are covered in a signs and symptoms section designed with side tabs for easy access.[books.google.com]
  • This combination is also clearly seen in the present study, which identified three cases where both perivenous and confluent demyelination were present side-by-side in the biopsy or autopsy specimens.[doi.org]
Fever
  • Poor functional outcome was related to initial high Expanded Disability Status Scale score and absence of fever.[doi.org]
  • The symptoms of ADEM appear rapidly, beginning with encephalitis-like symptoms such as fever, fatigue, headache, nausea and vomiting, and in the most severe cases, seizures and coma.[ninds.nih.gov]
  • However, ADEM usually has symptoms of encephalitis (such as fever or coma), which are usually not present in MS.[rarediseases.info.nih.gov]
  • 2 Signs and symptoms of measles-induced encephalitis Signs and symptoms of measles-induced encephalitis Measles symptoms Encephalitis symptoms Fever Fever Morbilliform rash Headache Cough Altered level of consciousness Coryza Behavioral disturbances[dx.doi.org]
Falling
  • As a result of this gait impairment, falling is a concern in patients with ataxia.[en.wikipedia.org]
  • Most forms of LE fall into two main categories: infectious encephalitis and autoimmune encephalitis.[encephalitis.info]
  • This is partly due to the fall in measles cases as a result of the MMR vaccine. PML is also quite rare. It mainly only affects people with a severely weakened immune system due to factors such as having an end-stage HIV infection (AIDS).[hse.ie]
  • These infections may be Epidemic (eg, due to arbovirus, echovirus, coxsackievirus, or poliovirus [in some underdeveloped countries]) Mosquito-borne arboviral encephalitides infect people during the spring, summer, and early fall when the weather is warm[merckmanuals.com]
  • The most common fall into 3 groups: 1) Herpes Viruses – HSV-1 (and HSV-2 to a much lesser extent), VZV, CMV, EBV, HHV-6.[errolozdalga.com]
Buffalo Hump
  • Metabolic: Corticosteroids cause a movement of body fat to the face and torso, resulting in " moon face ", "buffalo hump", and "pot belly" or "beer belly", and cause movement of body fat away from the limbs.[en.wikipedia.org]
Palpitations
  • This edition's highlights include new chapters on palpitations, cystic fibrosis, travel related emergencies, and ultrasound and a new appendix on practice pathways.[books.google.com]
Facial Swelling
  • Some were felt to be vasovagal reactions, and some included slight facial swelling or pallor. It was unclear whether any of these reactions were anaphylactic.[nap.edu]
Delusion
  • This can lead to changes in a person's thinking and behaviour, such as: delusions - believing things that are obviously untrue paranoia - a belief that people are 'out to get you' and are actively plotting against you Some cases of autoimmune encephalitis[hse.ie]
  • During the entire course, the patient showed no evidence of auditory hallucinations, delusions or other symptoms suggestive of schizophrenia. Overall, his presentation remained stable during follow-up. The timeline is shown in Fig. 3.[springerplus.springeropen.com]
Head Banging
  • New Features: New topics for this edition include: Amenorrhea, Asberger Syndrome, Dental Trauma, Head banging, Mental Retardation, Narcolepsy, Obsessive Compulsive Disorder, Separation Anxiety and Social Anxiety Free 30 Day Access to the 5minuteconsult[books.google.com]
Amenorrhea
  • New Features: New topics for this edition include: Amenorrhea, Asberger Syndrome, Dental Trauma, Head banging, Mental Retardation, Narcolepsy, Obsessive Compulsive Disorder, Separation Anxiety and Social Anxiety Free 30 Day Access to the 5minuteconsult[books.google.com]
Meningism
  • […] in other infectious and parasitic diseases classified elsewhere G03 Meningitis due to other and unspecified causes G03.0 Nonpyogenic meningitis G03.1 Chronic meningitis G03.2 Benign recurrent meningitis [Mollaret] G03.8 Meningitis due to other specified[icd10data.com]
  • No reports of meningitis occurred more than 14 days after vaccination. Eight (62%) were primary vaccinees.[doi.org]
  • ASEPTIC MENINGITIS Clinical Description Aseptic meningitis is defined as an inflammation of the meninges associated with pleocytosis of the CSF.[nap.edu]
  • However, there can be overlap of laboratory values for viral and bacterial encephalitis, or meningitis (see Table I. Cerebrospinal fluid findings in meningitis).[infectiousdiseaseadvisor.com]
Polyradiculoneuropathy
  • A Lennon, Sean J Pittock, Jennifer A Tracy, Karl N Krecke, Kimberly K Amrami, Eric M Poeschla, Robert Orenstein, Bernd W Scheithauer, James J Sejvar, Stacy Holzbauer, Aaron S DeVries and P James B Dyck, An outbreak of neurological autoimmunity with polyradiculoneuropathy[doi.org]
Spastic Paraplegia
  • paraplegia G04.2 Bacterial meningoencephalitis and meningomyelitis, not elsewhere classified G04.3 Acute necrotizing hemorrhagic encephalopathy G04.31 Postinfectious acute necrotizing hemorrhagic encephalopathy G04.32 Postimmunization acute necrotizing[icd10data.com]
Cerebellar Sign
  • Multifocal neurological deficits consisting of combinations of pyramidal and cerebellar signs are very common, as are cranial neuropathies, including bilateral optic neuritis, encountered more frequently in ADEM than MS (table 2).[jnnp.bmj.com]

Workup

  • Other features include a Chief Complaints section addressing the workup and treatment of 50 signs and symptoms, plus a medication index, syndromes glossary, surgical glossary, laboratory values, and tables all for quick reference saving you time and helping[books.google.com]
  • Workup should include a thorough history and physical exam to determine if the clinical course could be consistent with AE.[aealliance.org]
  • The routine diagnostic workup of M. pneumoniae encephalitis should therefore aim for the detection of M. pneumoniae antibodies in both CSF and serum, in addition to M. pneumoniae PCR in CSF.[journals.plos.org]
  • Diagnosis [ edit ] H&E stain of a colonic biopsy showing a crypt abscess, a classic finding in ulcerative colitis The initial diagnostic workup for ulcerative colitis includes the following: [14] [38] A complete blood count is done to check for anemia[en.wikipedia.org]
Jamestown Canyon Virus
  • Canyon virus encephalitis Paraneoplastic encephalitis Paraneoplastic encephalomyelitis Paraneoplastic limbic encephalitis Pyogranulomatous meningoencephalomyelitis Systemic lupus erythematosus encephalitis Applies To Noninfectious acute disseminated[icd9data.com]

Treatment

  • Reference is easy thanks to a unique 3-part structure covering general aspects of treatment; reviews of every agent; and details of treatments of particular infections.[books.google.com]
  • The aim of this review was to describe available data concerning diagnosis and treatment of postinfectious encephalitis, focusing on acute disseminated encephalomyelitis (ADEM) and acute hemorrhagic leukoencephalitis (AHLE).[ncbi.nlm.nih.gov]
  • Treatment Treatment for ADEM is targeted at suppressing inflammation in the brain using anti-inflammatory drugs.[ninds.nih.gov]

Prognosis

  • RECENT FINDINGS: The increasing availability of brain MRI studies has allowed a better delineation of diagnosis and prognosis of postinfectious central nervous system disorders.[ncbi.nlm.nih.gov]
  • Prognosis Corticosteroid therapy typically helps hasten recovery from most ADEM symptoms. The long-term prognosis for individuals with ADEM is generally favorable.[ninds.nih.gov]
  • Prognosis is also related to the antecedent factors.[neurologyindia.com]
  • "Clinical course and long-term prognosis of acute transverse myelopathy". Acta Neurologica Scandinavica. 81 (5): 431–5. doi : 10.1111/j.1600-0404.1990.tb00990.x. PMID 2375246. Chamberlin SL, Narins B, eds. (2005).[en.wikipedia.org]

Etiology

  • Abstract A 33-year-old man and his 32-year-old sister developed, with an interval of 2 years, an acute fatal encephalitis following an upper respiratory tract infection of unknown etiology. Autopsy documented postinfectious encephalitis in both.[ncbi.nlm.nih.gov]
  • The precise pathogenesis of infection by JC virus, the etiologic human papovavirus, remains elusive, but much has been learned since the original description of the pathologic entity PML in 1958.[journals.lww.com]
  • Abstract Purpose of review In this review, the possible etiology, clinical characteristics, diagnosis, and treatment of acute disseminated encephalomyelitis (ADEM) are discussed.[dx.doi.org]

Epidemiology

  • Epidemiologic variables, risk factors, clinical course, laboratory and radiographic findings, neuropathology and treatment data were analyzed.[dx.doi.org]
  • Conclusion Epidemiological Evidence Proposed Biological Mechanism Archives References Conclusion Older formulations of rabies vaccine did cause Acute Disseminated Encephalomyelitis (ADEM), but newer formulations of rabies vaccine have not been shown to[vaccinesafety.edu]
  • Abstract OBJECTIVE: To determine the temporal trends in the epidemiology of acute disseminated encephalomyelitis (ADEM) and hospitalization outcomes in the US from 2006 through 2014.[ncbi.nlm.nih.gov]
Sex distribution
Age distribution

Pathophysiology

  • However, the pathophysiology of ADEM is not fully understood.[vaccinesafety.edu]
  • Autoimmune Encephalitis Classification Autoimmune encephalitis Autoimmune encephalitis Diagnosis Autoimmune Encephalitis Pathophysiology[news-medical.net]
  • Current understanding of the pathophysiology of post-herpes simplex virus encephalitis movement disorders proposes 2 possible mechanisms that may be responsible: reinfection with the resumption of viral replication, or a postinfectious, immune-mediated[pediatrics.aappublications.org]
  • Pathophysiology Multiple sclerosis (MS) and acute disseminated encephalomyelitis (ADEM) bear a close pathological resemblance, each resembling the pathology of experimental allergic encephalomyelitis (EAE).[emedicine.medscape.com]

Prevention

  • METHODS: Using the uniform criteria provided by The Council of State and Territorial Epidemiologists (CSTE) and Centers for Disease Control and Prevention (CDC), we diagnosed postinfectious encephalitis among patients admitted to The First Hospital of[ncbi.nlm.nih.gov]
  • What they ... [ Read Full Story ] May 10, 2019 If your provider is ordering nebulizers and the drugs used in them for their patients, here are things in the documentation that will help prevent a resubmission to Medicare and ease medical codi... [ Read[coder.aapc.com]
  • "Supportive devices for preventing and treating subluxation of the shoulder after stroke". Cochrane Database Syst Rev (1): CD003863. doi : 10.1002/14651858.CD003863.pub2. PMID 15674917.[en.wikipedia.org]

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