Encephalitis is the infection or inflammation of the brain tissue which occurs mostly due to viral infections. The inflammation can be due to autoimmune causes and it can lead to swelling of the brain’s parenchymal tissue.
Main two types of encephalitis are,
- Infectious encephalitis
- Autoimmune encephalitis
Infectious Encephalitis
The most common cause of infectious encephalitis is viral infections which include Herpes simplex type 1 and 2, Varicella-Zoster Virus, and Enteroviruses. Also, other common viruses such as Measles, Mumps, and Rubella can cause infectious encephalitis.
Viruses Carried by Mosquitoes
- Japanese encephalitis
- Zika
- Chikungunya
Those viruses can also result in infectious encephalitis. Although viruses are the commonest cause of encephalitis they can’t be considered as the only microorganism that causes encephalitis, as Bacteria, Fungi, and Parasites also rarely can cause encephalitis.
Autoimmune Encephalitis
Autoimmune conditions are the reactions that occur in our body attacking our immune system. In this condition, autoantibodies arise in the body that attack the various proteins and receptors in the brain. The main causes for the production of autoantibodies and autoimmune reactions in the body are not yet detected but benign as well as Malignant Tumors can be one of the causes.
Signs and Symptoms
Symptoms of acute encephalitis usually get worse over time while starting from mild flu, like symptoms that worsen with time to alternations of mental status and impairment of higher functioning. Also, these signs and symptoms can be misdiagnosed as other diseases and ignored as they are not very specific. Hence it is very important to consult a medical doctor if you get these below symptoms.
Physical Symptoms
- Fever
- Headache
- Fits
- Abnormal movements
- Increased sensitivity to light and sound
- Neck stiffness
- Loss of consciousness
- Weakness or paralysis in the arms and legs
- Double vision
- Impairment of speech or hearing
- Coma
Cognitive Symptoms
- Excessive sleepiness
- Confusion and disorientation
- Irritability
- Anxiety
- Hallucinations
- Memory loss
- Behavioral changes
- Cognitive impairment
Diagnosis of Encephalitis
Mainly the diagnosis will be based on the patient’s medical history.
Examination and Investigations
- CT
- MRI
- Lumbar puncture
- Electroencephalogram
- Blood tests
- Urine and stool assessment for identify microorganisms that can cause encephalitis
Long Term Complications
- Memory impairment
- Personality changes as irritability
- Epilepsy
- Hearing loss
- Visual defects
- Easy fatiguability
Management
It is very important to identify the disease early and treat it appropriately to minimize the fatalities. Also, these patients will require ICU care to monitor and treat emergencies such as Fits, Cardiac Arrhythmias, and Brain Swelling.
Pharmacological Management
- Antiviral medications
- Antibacterial medications
- Immune drugs as Steroids and Intravenous Immunoglobulin
- Drugs that control fits
Prevention of Encephalitis
- It is important to get your vaccinations on time to protect from the viruses as Measles, Mumps, Rubella and etc.
- Use insect repellents and proper precautions to protect yourself from mosquitoes.
- Social distancing, proper hygiene practices also can protect you from getting infected pf pathogenic microorganisms.
References
- Kumar and Clerk’s Clinical Medicine -8th Edition- Parveen Kumar, Michael Clark
- Oxford Handbook of Clinical Medicine – 10th Edition
