Encephalitis Literally Means an Inflammation of the Brain
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8/8/2019 Encephalitis Literally Means an Inflammation of the Brain
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Encephalitis literally means an inflammation of the brain, but it usually refers to brain
inflammation caused by a virus. It's a rare disease that occurs in approximately 0.5 per 100,000
individuals most commonly in children, the elderly, and people with weakened immunesystems (e.g., those with HIV/AIDS or cancer).
Although several thousand cases of encephalitis (also called acute viral encephalitis or aseptic
encephalitis) are reported to the Centers for Disease Control and Prevention (CDC) every year,experts suspect that many more may go unreported because the symptoms are so mild.
Signs and Symptoms
Symptoms in milder cases of encephalitis usually include:
fever
headache
poor appetite
loss of energy
a general sick feeling
In more severe cases of encephalitis, a person is more likely to experience high fever and any of a
number of symptoms that relate to the central nervous system, including:
severe headache
nausea and vomiting
stiff neck
confusion
disorientation
personality changes convulsions (seizures)
problems with speech or hearing
hallucinations
memory loss
drowsiness
coma
It's harder to detect some of these symptoms in infants, but important signs to look for include:
vomiting a full or bulging soft spot (fontanel)
crying that doesn't stop or that seems worse when an infant is picked up or handled in
some way
body stiffness
Because encephalitis can follow or accompany common viral illnesses, there sometimes are signs
and symptoms of these illnesses beforehand. But often, the encephalitis appears without warning.
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Causes
Because encephalitis can be caused by many types of germs, the infection can be spread in
several different ways.
One of the most dangerous and most common causes of encephalitis is the herpes simplex virus
(HSV). HSV is the same virus that causes cold sores around the mouth, but when it attacks thebrain it may occasionally be fatal. Fortunately, HSV encephalitis is very rare.
Encephalitis can be a very rare complication ofLyme disease transmitted by ticks or ofrabies
spread by rabid animals.
Mosquitoes can also transmit the viruses for several types of encephalitis, including West Nile
encephalitis, St. Louis encephalitis, and Western Equine encephalitis. Over the last several years
in the United States, there's been concern about the spread ofWest Nile virus, which is
transmitted to humans by mosquitoes that pick up the virus by biting infected birds.
Milder forms of encephalitis can follow or accompany common childhood illnesses, includingmeasles, mumps, chickenpox, rubella (German measles), and mononucleosis. Viruses like
chickenpox spread mostly via the fluids of the nose and throat, usually during a cough or sneeze.
Less commonly, encephalitis can result from a bacterial infection, such as bacterial meningitis, or
it may be a complication of other infectious diseases like syphilis. Certain parasites, liketoxoplasmosis, can also cause encephalitis in people with weakened immune systems.
Contagiousness
Brain inflammation itself is not contagious, but any of the various viruses that cause encephalitiscan be. Of course, just because a child gets a certain virus does not mean that he or she will
develop encephalitis. Still, to be safe, children should avoid contact with anyone who has
encephalitis.
Prevention
Encephalitis cannot be prevented except to try to prevent the illnesses that may lead to it.Encephalitis that may be seen with common childhood illnesses can be largely prevented through
properimmunization. Have your kids immunized according to the immunization schedule
recommended by your doctor. Kids should also avoid contact with anyone who already hasencephalitis.
In areas where encephalitis can be transmitted by insect bites, especially mosquitoes, kids should:
Avoid being outside at dawn and dusk (when mosquitoes are most active).
Wear protective clothing like long sleeves and long pants.
Use insect repellent.
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Also, all standing water around your home should be drained, including buckets, birdbaths,
flowerpots, and tire swings because these are breeding grounds for mosquitoes.
To avoid tick bites:
Limit kids' contact with soil, leaves, and vegetation.
Have kids wear long-sleeved, light-colored shirts and long pants when outdoors. Check your kids and your pets frequently for ticks.
Duration
For most forms of encephalitis, the acute phase of the illness (when symptoms are the most
severe) usually lasts up to a week. Full recovery can take much longer, often several weeks or
months.
Diagnosis
Doctors use several tests to diagnose encephalitis, including:
imaging tests, such as computed tomography (CT) scans or magnetic resonance imaging(MRI), to check the brain for swelling, bleeding, or other abnormalities
electroencephalogram (EEG), which records the electrical signals in the brain, to check for
abnormal brain waves
blood tests to confirm the presence of bacteria or viruses in the blood, and whether a
person is producing antibodies (specific proteins that fight infection) in response to a germ
lumbar puncture, or spinal tap, in which cerebrospinal fluid (the fluid that surrounds thebrain and spinal cord) is checked for signs of infection
Treatment
Some children with very mild encephalitis can be monitored at home, but most will need care in a
hospital, usually in an intensive care unit. Doctors will carefully monitor their blood pressure,
heart rate, and breathing, as well as their body fluids, to prevent further swelling of the brain.
Because antibiotics aren't effective against viruses, they aren't used to treat encephalitis. However,antiviral drugs can be used to treat some forms of encephalitis, especially the type caused by the
herpes simplex virus. Corticosteroids may also be used in some cases to reduce brain swelling. If
a child is having seizures, anticonvulsants may also be given.
Over-the-counter (OTC) medications, like acetaminophen, can be used to treat fever andheadaches.
Many people with encephalitis make a full recovery. In some cases, swelling of the brain can lead
to permanent brain damage and lasting complications like learning disabilities, speech problems,
memory loss, or lack of muscle control. Speech, physical, or occupational therapy may be
necessary in these cases. It's difficult to predict the outcome for each patient at the time the illness
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begins, but some types of encephalitis are known to cause more serious complications, such as
Japanese Encephalitis
Rarely, if the brain damage is severe, encephalitis can lead to death. Infants younger than 1 year
and adults older than 55 are at greatest risk of death from encephalitis.
When to Call the Doctor
Call your doctor if your child has a high fever, especially if he or she also has a childhood illness
(measles, mumps, chickenpox) or is recovering from one.
Seek immediate medical attention if your child has any of the following symptoms:
severe headache
convulsions (seizures)
stiff neck
inability to look at bright lights
double vision difficulty walking
problems with speech or hearing
difficulty moving an arm or leg
loss of sensation anywhere in the body
sudden personality changes
problems with memory
extreme drowsiness or lethargy
loss of consciousness
If your infant has any of the following symptoms, seek immediate medical care:
high fever or any fever higher than 100.4 F (38 C) in infants younger than 3 months old
fullness or bulging in the soft spot
any stiffness
floppiness or decreased tone
lethargy
poor appetite or reduced feeding
vomiting
crying that won't stop
Assessment
1. Fever, headache, nausea and vomiting, mental status changes.2. Meningeal signs nuchal rigidity (stiff neck), photophobia.3. Seizures, motor deficits, personality changes.4. Signs of brain stem involvement, such as nystagmus, extraocular nerve palsies, hearing
loss, dysphagia, and respiratory dysfunction.
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