Encephalitis
37636
224799804
2008-07-10T13:47:44Z
198.54.202.74
/* Treatment */
{{Infobox_Disease |
Name = Encephalitis |
Image = |
Caption = |
DiseasesDB = 22543 |
ICD10 = {{ICD10|A|83||a|80}}-{{ICD10|A|86||a|80}}, {{ICD10|B|94|1|b|90}}, {{ICD10|G|05||g|00}} |
ICD9 = {{ICD9|323}} |
ICDO = |
OMIM = |
MedlinePlus = |
eMedicineSubj = emerg |
eMedicineTopic = 163 |
MeshID = D004660 |
}}
'''Encephalitis''' is an [[Acute (medical)|acute]] [[inflammation]] of the [[brain]], commonly caused by a [[virus|viral]] [[infection]]. It can be caused by a [[bacteria]]l 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 [[protozoa]]l infestations, such as [[toxoplasmosis]], [[malaria]], or [[primary amoebic meningoencephalitis]], can also cause encephalitis in people with [[immune deficiency|compromised]] [[immune system]]s. [[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.
==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.
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==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 encephalitis<ref>[http://www.medscape.com/viewarticle/414787_3 Tick-Borne Encephalitis]</ref>) 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. [[Computed tomography|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|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|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. 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==
<div style="-moz-column-count:3; column-count:3;">
*[[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]]
</div>
==References==
{{reflist}}
==External links==
* http://www.encephalitis.info resource providing evidence based support to people affected and professionals
* [http://www.who.int/health_topics/encephalitis/en/ WHO: Encephalitis]
* [http://www.emedicinehealth.com/articles/17223-1.asp eMedicine-1 ] and [http://www.emedicinehealth.com/articles/17223-2.asp eMedicine-2] Information on the causes, symptoms, and treatment options for Encephalitis.
* [http://www.encephalitisglobal.org Encephalitis Global, Inc.] Website offering information and support to encephalitis survivors, caregivers and loved ones. Encephalitis Global Inc. is a USA 501(c)(3) public charity; annual FACES Encephalitis Conference information available at the website.
* [http://www.uiowa.edu/~c064s01/nr059.htm A case study of a Limbic Encephalitis patient]
* [http://www.garrettmtaylor.com/ A website about Garrett Taylor a 2 year old who lost his life after a battle with encephalitis]
*[http://www.ninds.nih.gov/disorders/encephalitis_meningitis/detail_encephalitis_meningitis.htm]
{{Diseases of the nervous system}}
[[Category:Neurological disorders]]
[[Category:Encephalitis|*]]
[[Category:Infectious diseases]]
[[Category:Inflammations]]
[[Category:Greek loanwords]]
[[bg:Енцефалит]]
[[de:Enzephalitis]]
[[es:Encefalitis]]
[[eo:Encefalito]]
[[fr:Encéphalite]]
[[hi:मस्तिष्क ज्वर]]
[[ko:뇌염]]
[[hr:Encefalitis]]
[[id:Ensefalitis]]
[[it:Encefalite]]
[[la:Encephalitis]]
[[hu:Agyvelőgyulladás]]
[[nl:Hersenontsteking]]
[[ja:脳炎]]
[[pl:Zapalenie mózgu]]
[[pt:Encefalite]]
[[ru:Энцефалит]]
[[simple:Encephalitis]]
[[fi:Aivotulehdus]]
[[sv:Hjärninflammation]]
[[te:మెదడువాపు]]
[[vi:Viêm não]]
[[tr:Ensefalit]]
[[zh:脑炎]]