Encephalitis is an inflammatory process in the area of a brain substance caused by infectious, toxic, allergic, and metabolic causes.
Two large groups of encephalitis are distinguished:
- primary encephalitis, which initially affects the brain,
- secondary encephalitis, in which brain damage is one of the symptoms of the disease.
Primary encephalitis may be caused by viruses, protozoa or microbes.
Secondary encephalitis may be a manifestation allergies, parasitosis, toxicosis, drug overdose, metabolic disorders, etc.
Depending on various criteria, several classifications of encephalitis can be distinguished, besides the above. Based on the severity of the course, one can distinguish over-acute, acute, sub-acute, recurrent and chronic forms.
On the depth and localization of the lesion can be identified encephalitis with lesions of the cerebellum, stem encephalitis, cortical or subcortical. With the defeat of the white matter of the brain, leukoencephalitis occurs, with the defeat of the gray matter, polyencephalitis occurs, with the full involvement of the brain tissue, panencephalitis occurs with symptoms of necrosis or hemorrhage. In addition, encephalitis can be complicated and uncomplicated.
The most basic and frequently encountered are:
- tick-borne encephalitis,
- mosquito or Japanese encephalitis,
- lethargic, epidemic encephalitis,
- flu encephalitis
- measles encephalitis
- post-vaccination encephalitis.
The basis for the diagnosis of encephalitis – clinical manifestations, brain symptoms and indications of tick bites, mosquitoes, childhood infections or vaccinations. At the same time, to confirm the diagnosis, it is necessary to isolate the pathogen by blood analysis or to identify other causes – allergens, antibodies, toxins.
- general and biochemical blood tests, urine tests,
- blood culture for sterility,
- puncture with obtaining cerebrospinal fluid,
- holding a reg or EEG, fundus examination,
- CT scan or MRI ,
- if necessary, a biopsy is performed.
Differential diagnostics should be carried out between different types of encephalitis, between primary and secondary forms, as well as between encephalitis and meningitis, toxic encephalopathy.
Clinical manifestations of encephalitis can differ quite strongly depending on the cause and depth of the lesion, on whether the lesion was initially primary or secondary. But in general, common signs can be identified among all encephalitis.
The incubation period for encephalitis varies from one to two weeks, with secondary nature of encephalitis it is absent – they arise against the background of the existing disease.
The first signs of encephalitis can be permanent weakness in the limbs, both in the arms and legs, pain and discomfort in the neck muscles and neck.
The specificity of the course and the signs are attributed to their causes, and the degree of manifestation of the symptoms, the time of their occurrence may be different.
Usually encephalitis occurs in acute form with chills, severe fever up to several days. Can be
- general malaise,
- painful headache, at its height with nausea and vomiting, not bringing relief,
- sleep disorders and insomnia,
This may be a sharp red skin of the face, upper chest and neck, red mouth and pharynx.
There may be aches and pains in the body and joints, pain in the muscles. In some cases, with encephalitis, consciousness may be impaired to varying degrees, from mild misting to deep coma with no response to stimuli.
Most often, encephalitis is mild or moderate.
Primary form encephalitis
In primary forms of encephalitis, there may be an acute or subacute onset of the disease; they may be the first to appear.
- symptoms of toxicosis,
- headaches of increasing intensity
- severe weakness
- feverish state.
Against the background of these symptoms, disturbances of consciousness can occur – the patient cannot accurately navigate in space or time, there may be manifestations of delusions, hallucinations of a visual, taste, sound or tactile nature.
On average, the brain stage lasts for several days, but acute forms can lead to complications or transition to chronic forms.
In secondary forms, against the background of an existing infection or a somatic disease, neurological manifestations may appear dramatically in the form of a stroke – signs of vascular catastrophes in the brain or its edema appear.
Neurological symptoms may change over time – consciousness is disturbed from mild stupor to a coma.
Manifestations of cerebral symptoms in encephalitis can be paralysis or paresis of the limbs or muscles of the body, seizures epilepsy, convulsions, increased intracranial pressure, intellectual impairment, psychosis.
First of all. With a known pathogen, active therapy for its suppression is carried out – antiviral, interferon therapy, intravenous antibiotics in large doses.
To combat cerebral edema, strong diuretics and dehydration are shown – lasix, furosemide, mannitol.
When allergies are shown antihistamines, hormone therapy (prednisone, hydrocortisone).
To improve the nutrition of brain tissue, drip solutions of dextran, glucose with insulin, potassium chloride, isotonic solution are prescribed.
If necessary, use oxygen therapy or mechanical ventilation, therapy to maintain the heart and blood vessels, vitamins, drugs to improve brain metabolism – piracetam, cinnarizine, cavinton.
If necessary, conduct anticonvulsant, antipsychotic therapy, use antipyretic and lytic mixtures, antidepressants.
One of the main complications is the development of deaths, organic brain damage and the development of irreversible paralysis and paresis. All these complications lead to disability.
The majority of encephalitis, the treatment of which was started on time, proceeds mildly and ends with recovery.