Encephalitis is an inflammation of the brain that is usually caused by a direct viral infection. Common causes include herpes simplex virus, enteroviruses, and mosquito-borne viruses. Symptoms include fever, headache, seizures, confusion, drowsiness, and loss of consciousness. Diagnostic tests include brain imaging, spinal taps, and tests of blood, urine, and throat samples to identify the infectious agent. Treatment focuses on relieving swelling with corticosteroids, treating the underlying infection, and providing supportive care. Those who survive may require long-term physical, occupational, and speech therapy to recover lost functions.

1. ENCEPHALITIS
Jilu John:
1st Year M.Sc Nursing

2. Anatomy of the Brain
Overview
• Controls all functions of the body,
interprets information from the outside
world, and embodies the essence of the
mind and soul.
• Intelligence, creativity, emotion, and
memory are a few of the many things
governed by the brain.

4. Parts Of The Brain
• The cerebrum
• It is the largest part of the brain and is composed of right and
left hemispheres. It performs higher functions like interpreting
touch, vision and hearing, as well as speech, reasoning,
emotions, learning, and fine control of movement.
• The cerebellum
• is located under the cerebrum. Its function is to coordinate
muscle movements, maintain posture, and balance.

5. Cont…
• The brainstem
• It includes the midbrain, pons, and medulla. It acts as a
relay center connecting the cerebrum and cerebellum to
the spinal cord. It performs many automatic functions
such as breathing, heart rate, body temperature, wake
and sleep cycles, digestion, sneezing, coughing,
vomiting, and swallowing. Ten of the twelve cranial
nerves originate in the brainstem.

7. DEFINITION
Encephalitis is an inflammation of the brain,
usually caused by a direct viral infection or a
hypersensitivity reaction to a virus or foreign
protein.

8. INCIDENCE
• Encephalitis occurs 1 in every 1000 cases of
measels.
• The incidence rate is difficult to determine
because the disease is often under reported.
• Herpes virus accounts for most cases of
encephalitis in the world.

9. ETIOLOGY
• Herpes simplex virus (HSV)
• Enteroviruses. These viruses include the poliovirus
which usually cause an illness with flu-like symptoms,
eye inflammation and abdominal pain.
• Mosquito-borne viruses. These viruses can cause
infections such as West Nile, St. Louis.
• Tick-borne viruses. The Powassan virus is carried by
ticks and causes encephalitis in the Midwestern United
States.

10. Cont…
• Rabies virus. Infection with the rabies virus, which
is usually transmitted by a bite from an infected animal.
• Childhood infections. Common childhood
infections — such as measles (rubeola), mumps and
German measles (rubella) used to be fairly common
causes of secondary encephalitis

12. Types
ENCEPHALITIS
PRIMARY
HERPES SIMPLEX
ARBOVIRAL
Tick-borne
Encephalitis
Japanese
Encephalitis
SECONDARY

13. CONT..
• Primary Encephalitis. When there is direct
viral infection of the brain or spinal cord, it is
called primary encephalitis.
• Secondary Encephalitis refers to an
infection which started off elsewhere in the body
and then spread to the brain.

14. Cont…
• Herpes Simplex Encephalitis (HSE) It is
an acute illness that causes both general and focal
signs of cerebral dysfunction.
• Arboviral Encephalitis: Inflammation of the
brain (encephalitis) caused by infection with an
arbovirus, a virus transmitted by a mosquito, tick or
another arthropod.

15. PATHOPHYSIOLOGY
• •{Depends on the virus}
Direct Viral Destruction Of Cells
Post-infectious Inflammatory Or Immune- Mediated Response
Infect Brain Parenchyma And Neuronal Cells
Demyelination Of Cells
Infection

16. Clinical Manifestation
• Encephalitis generally begins with fever and headache.
• The symptoms rapidly worsen,
• Seizures (fits)
• Confusion
• Drowsiness
• Muscle weakness
• Problems with speech or hearing
• Loss of consciousness and even coma

18. Diagnostic Tests
• Brain imaging. MRI or CT images can reveal any
swelling of the brain or another condition that might be
causing your symptoms, such as a tumor.
• Spinal tap (lumbar puncture). A needle
inserted into your lower back removes cerebrospinal fluid
(CSF). Changes in this fluid can indicate infection and
inflammation in the brain. Sometimes samples of CSF
can be tested to identify the virus or other infectious
agent.

19. Cont…
• Other Lab Tests. Samples of blood, urine or
excretions from the back of the throat can be tested for
viruses or other infectious agents.
• Electroencephalogram (EEG). Electrodes
affixed to your scalp record the brain's electrical activity.
Certain abnormal patterns may indicate a diagnosis of
encephalitis.

20. Cont…
• Brain Biopsy. Rarely, a small sample of brain
tissue might be removed for testing. Brain biopsy is
usually done only if symptoms are worsening and
treatments are having no effect.

21. Management
 Corticosteroids are used to reduce brain swelling
and inflammation.
 Sedatives may be needed for irritability or
restlessness.
 When the diagnosis of HSE is suspected or has been
established, Acyclovir is the treatment of choice (for 14
days).
Corticosteroids may be administered to reduce the
brain's inflammation, especially in cases of post-
infectious (secondary) encephalitis.

22. Supportive care
• Breathing assistance, as well as careful monitoring of
breathing and heart function
• Intravenous fluids to ensure proper hydration and levels
of essential minerals
• Anti-inflammatory drugs, such as corticosteroids, to
reduce swelling and pressure within the skull
• Anticonvulsant medications, such as phenytoin
(Dilantin), to stop or prevent seizures

23. FOLLOW-UP
• Physical therapy to improve strength, flexibility,
balance, motor coordination and mobility
• Occupational therapy to develop everyday skills and
to use adaptive products that help with everyday activities
• Speech therapy to relearn muscle control and
coordination to produce speech
• Psychotherapy to learn coping strategies and new
behavioral skills to improve mood disorders or address
personality changes

24. NursingDiagnosis
• 1)Impaired urinary elimination r/t diminished bladder
cues or impaired ability to recognize bladder cues
secondary to brain infection.
• (2) Impairedcommunication r/t cognitive impairment
secondary to encephalitis.
• (3) Delayed Growth and Development r/t disruption of
peer relationships and loss ofindependence and
autonomy secondary to encephalitis.
• (4) Risk for shock r/t infection

25. ASSIGNMENT
• Nursing Intervention And Rationale Of
Encephalitis