Encephalitis

Question 1

Simply, what does encephalitis mean?

Answer 1

Inflammation of the brain

Question 2

What is the most common cause of encephalitis in children?

Answer 2

Viral infection of HSV-1

Question 3

What is the most common cause of encephalitis in neonates?

Answer 3

HSV-2 from genital herpes

Question 4

Name some viral cuases of encephalitis

Answer 4

HSV-1
HSV-2
Varicella Zoster virus (chickenpox)
Cytomegalovirus (immunodeficiency)
Epstein-Barr virus (infectious mononucleosis)
Enterovirus
Adenovirus
Influenza virus
Polio
Mumps
Rubella
Measles

Question 5

What vaccine is important when investigating encephalitis

Answer 5

MMR and polio

Question 6

How does encephalitis usually present?

Answer 6

Altered consciousness
Altered cognition
Unusual behaviour
Acute onset of focal neurological symptoms
Acute onset of focal seizures
Fever

Question 7

How does a virus cause encephalitis?

Answer 7

Infecting via bloodstream or nerve endings and damaging brain tissue leading to inflammation and swelling.

Question 8

How is encephalitis diagnosed?

Answer 8

Lumbar puncture sending CSF for viral PCR testing (if contraindicated, do CT scan)
MRI to visualise
HIV testing

May do EEG
Swabs of throat or vesicles may help establish organism

Question 9

What are some contraindications to performing a lumbar puncture?

Answer 9

GCS < 9
Haemodynamically unstable
Active seizures
Post-ictal period

Question 10

What antiviral helps to treat HSV and VZV?

Answer 10

Aciclovir

Question 11

What antiviral helps to treat cytomegalivurs?

Answer 11

Ganciclovir

Question 12

What is repeated to ensure successful treatment before stopping antivirals?

Answer 12

Repeat lumbar puncture

Question 13

What are some complications of encephalitis?

Answer 13

Fatigue and prolonged recovery
Change in mood/personality
Changes to memory/cognition
Learning disability
Headaches
Chronic pain
Movement disorders
Sensory disturbance
Seizures
Hormonal imbalance