Let us assume that there is a 24−year−old woman, who arrives at the emergency room with her parents, who say that she has been acting strangely for a few days. They claim that she was silent and withdrawn. She has expressed discomfort with her throat, and she has a past with depression as well. What might the diagnosis be?
Encephalitis is a dangerous condition affecting the brain and must be treated immediately to prevent long−term consequences or death. The brain is inflammatory in encephalitis. There are numerous reasons, such as bacterial infection, insect bites, autoimmune inflammation, and viral infection. There are times when no cause is known, and encephalitis occasionally poses a life−threatening threat. Because it is hard to know how encephalitis will impact everyone, timely diagnosis and treatment are crucial. Encephalitis may produce no symptoms or mild flu−like clinical manifestations such as a fever or headache. The flu−like symptoms might occasionally be more severe.
Typical mild flu−like symptoms of viral encephalitis include −
Headache
Rigid neck
Fever
Muscle or joint aches
Weakness or weariness
The more severe indications and symptoms might sometimes include −
Hallucinations, agitation, or confusion
Seizures
Loss of feeling in or immobility in the body or facial regions
Muscle tremor
Issues with hearing or speaking
Consciousness loss (including coma)
Signs and symptoms in newborns and young children may also include −
Bulging in a baby's skull's soft areas
Nausea and diarrhea
Body rigidity
Having a poor feeding or not woke up to eat
Irritability
In many cases, the causative agent of encephalitis is unknown. Encephalitis can be brought on by autoimmune inflammation and bacterial, viral, and noninfectious inflammatory diseases.
Primary encephalitis − This disease develops when one virus or other substance directly penetrates the brain. The contamination may be widespread or confined to a single location. A dormant virus after a prior sickness may become active again as a primary infection.
Secondary encephalitis − This illness results from the immune system's inadequate response to an infection that has spread throughout the body. The immune system incorrectly targets healthy brain cells in addition to the ones that are infected. Secondary encephalitis, also called post−infection encephalitis, frequently happens two to three weeks after the initial illness.
The following viruses can cause encephalitis −
Virus of Herpes Simplex (HSV)
Other herpes viruses, including the varicella−zoster virus (which frequently causes chickenpox and shingles)
Enteroviruses frequently result in a disease with flu−like signs, eye irritation, and abdominal pain.
Virus−borne via mosquitoes
Virus−carrying ticks have a typical onset of symptoms in a week or so following a tick bite.
Rabies virus
Infections in children − Common childhood illnesses, including German measles (rubella), mumps, and measles (rubeola), were causative factors of secondary encephalitis.
The doctor will begin by performing a complete physical examination and reviewing your medical history. The physician might then suggest −
Brain Scan − Any brain swelling or disorder affecting your complaints, like a tumor, can be seen in an MRI or CT scan.
Spinal Tap (lumbar puncture) − A little portion of cerebrospinal fluid (CSF), the insulating fluid that covers the brain and spinal column, is taken out using a needle put into the lower back. Variations in this fluid may indicate brain inflammation and infection.
More lab tests − Testing for pathogens or other harmful bacteria can be done on samples of blood, urine, or byproducts from the rear of the throat.
Electroencephalogram (EEG) − The scalp is covered with electrodes that capture the brain's electrical activity. A prognosis of encephalitis may be made based on specific aberrant patterns.
Brain Biopsy − Rarely is a tiny specimen of brain tissue that may be taken for examination. Only when symptoms develop and therapy fails are brain biopsies typically performed.
The typical treatment regimen for mild encephalitis includes bed rest and staying hydrated.
Antiviral Drugs − The following antiviral drugs are frequently used to treat encephalitis −
Acyclovir (Zovirax) − Ganciclovir (Valcyte, Zirgan, etc). Certain viruses, such as those carried by insects, resist these medications.
Foscarnet (Foscavir) − Since the specific virus might not be found immediately or at all, medical professionals frequently advise starting acyclovir treatment immediately
Autoimmune encephalitis − Immunosuppressant medications, such as steroids, may be begun if the tests reveal an autoimmune etiology of encephalitis.
Supportive Care − Hospitalized patients with severe encephalitis may require −
Aid with breathing and close supervision of breathing and heartbeat
Intravenous fluids to achieve adequate hydration and mineral levels
Corticosteroids and other anti−inflammatory medications to lessen swelling and pressure inside the skull
Physical Therapy − Endurance, agility, equilibrium, motor coordination, and mobility exercises
Occupational Therapy − Utilizing adapted equipment to improve daily skills and abilities
Speech Therapy − to retrain muscular coordination and control to speak
Psychotherapy − to address personality changes or to treat mood problems and learn coping mechanisms
Encephalitis can strike anyone. Some elements that could raise the risk include −
Age − Some encephalitis is more prevalent or severe in different age ranges. Generally, the risk of most viral encephalitis is higher among younger children and older individuals.
Compromised immune system − More likely to affect individuals who have HIV/AIDS, take immune−suppressing medication or have another illness that compromises immunity.
Territorial divisions − In some areas, viruses spread by ticks or mosquitoes are widespread.
Season − The time/season of the year also matters.
Inflammation can harm the brain, leading to a coma or even death. Other issues could be temporary or continue for months. These issues can range greatly in intensity and can consist of −
Persistent tiredness
Lack of strength or muscle coordination
Behavioral shifts
Memory issues
Paralysis
Defects in the ears or the eyes
Speech disorders
Prevention
The best method to avoid being exposed to viruses that may result in viral encephalitis is to act swiftly. Try to −
Maintain proper hygiene. Especially after using the restroom and before and after meals, wash your hands frequently and completely with soap and water.
Never swap utensils. Do not share drinks and utensils.
Instill positive behaviors in kids. Ensure they maintain proper hygiene and refrain from sharing utensils at home and school.
Vaccinations − Maintain the efficacy of your child and your immunizations. Consult your doctor before your trip to learn about the needed vaccines for certain locations.
A hospital is needed to treat encephalitis, a brain infection. The symptoms can continue impairing brain function even after the illness. Severe symptoms of encephalitis might also include confusion, convulsions, or issues with mobility or senses, including sight or hearing. It takes time to reach the maximum recovery potential. Occasionally, months or years. The talents and quality of life can be maximized with rehabilitation and good self−care.
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