A brief presentation on encephalitis covering all it's causes, types and modalities of management. Helpful for delivering an overview lecture.

1. Encephalitis
By Dr Madeeha

2. Objectives
• To introduce and define the topic
• To explain types of encephalitis
• To enlist risk factors and etiology
• To explain clinical manifestation and diagnostic evaluation
• To explain management and prevention of encephalitis

3. Introduction
• Encephalitis is a rare yet serious disease that can be life-threatnening
• Encephalitis is an inflammation of the brain tissue
• The most common cause is viral infections.
• In rare cases it can be caused by bacteria or even fungi

4. Definition
• Encephalitis is the inflammation of the brain parenchyma

5. Types
• Primary Encephalitis- It occurs when a virus directly infects the brain and
spinal cord.
• Secondary Encephalitis- The condition results from immune reaction to
an infection elsewhere in the body which then spreads to the brain

6. Risk factors
• Older adults
• Children under age of one year
• People with weak immune systems

7. Etiology
• Primary(infectious) encephalitis:-
• Common viruses including HSV (herpes simplex virus) and EBV (Epstein Barr
virus)
• Childhood viruses including measles and mumps
• Arboviruses (spread by mosquitoes, ticks and other insects), including Japanese
encephalitis, West Nile encephalitis and tick-borne encephalitis.
• Secondary encephalitis:-
• Could be caused by a complication of a viral infection.

8. Clinical Manifestations
• Fever, headache, vomiting
• Stiff neck
• Lethargy (exhaustion)
• Confusion, drowsiness, hallucinations
• Slower movements
• Coma
• Seizures
• Irritability, sensitivity to light, unconsciousness

9. Pathophysiology
• Diffuse cerebral edema, congestion and hemorrhages
• Necrosis and degeneration of neurons
• Meningeal congestion with mononuclear infilteration, perivascular tissue necrosis
and myelin breakdown
• Glial proliferation
• Demyelination, vascular and perivascular destruction and cerebral cortical
involvement
• In case of rabies and herpes simplex infection, specific inclusions are identified.
Characteristic pathological changes are found in falciparum malaria.

10. Diagnostic evaluation
• Careful health history and physical examination
• CSF study helps to differentiate the condition from meningitis
• Blood examination for sugar, urea, electrolytes and metabolic products
• Urine examination, toxicologic study and virological study
• CT scan
• EEG

11. Complications
• Loss of memory, behavioural/personality changes
• Epilepsy
• Fatigue, physical weakness
• Intellectual disability, lack of muscle coordination
• Vision problems, hearing problem, speaking issues
• Coma, difficulty breathing
• Death

12. Management
• A. MEDICAL MANAGEMENT
1. Pharmacological management:-
• Anti-inflammatory drugs and antipyretics- acetaminophen (Tylenol),
ibuprofen and naproxen sodium, to relieve headache and fever
• Antiviral drugs
• Acyclovir, ganciclovir

13. continued
• Mannitol or glycerol may be needed to reduce ICP.
• Corticosteroids (dexamethasone)
• Antibiotics
• Vitamin and mineral supplementation
• IV fluid therapy and dopamine to be given to treat shock and fluid-
electrolyte imbalance
• Anticonvulsive drugs

14. 2. Non-pharmacological Management
• Oxygenation to be provided by nasal cannula
• Mechanical ventilation is necessary in cardio-respiratory insufficiency

15. THANK YOU
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