Encephalitis is an inflammation of the brain that is often caused by a viral infection. Common viruses that can cause encephalitis include arboviruses transmitted by mosquitoes or ticks, enteroviruses like echovirus and coxsackievirus, herpes simplex virus type 1, and the amoeba that causes amebic meningoencephalitis found in fresh water. Symptoms of encephalitis include fever, nausea, vomiting, neck stiffness, changes in mental status, and neurological deficits. Management involves monitoring for increased intracranial pressure, administering antiviral medications, and providing rehabilitation for neurological problems.

1. JOHNY WILBERT, M.SC[N]
LECTURER,
APOLLO INSTITUTE OF HOSPITAL MANAGEMENT AND ALLIED
SCIENCE

2. 1. Encephalitis is an inflammation of the
brain parenchyma and often of the meninges.
2. It affects the cerebrum, brainstem, and
cerebellum.
3. It most often is caused by a viral agent,
although bacteria, fungi, or parasites also
may be involved.
4. Viral encephalitis is almost always
preceded by a viral infection.

3. Transmission
1. Arboviruses can be transmitted to human
beings
through the bite of an infected mosquito or tick.
2. Echovirus, coxsackievirus, poliovirus, herpes
zoster virus, and viruses that cause mumps and
chickenpox are common enteroviruses associated
with encephalitis.

4. 3. Herpes simplex type 1 virus can cause viral
encephalitis.
4. The organism that causes amebic
meningoencephalitis can enter the nasal mucosa
of persons swimming in warm fresh water—for
example, in a pond or lake.

5. Clinical manifestation
1. Presence of cold sores, lesions, or ulcerations
of the oral cavity
2. History of insect bites and swimming in fresh
water
3. Exposure to infectious diseases
4. Travel to areas where the disease is prevalent
5. Fever

6. 6. Nausea and vomiting
7. Nuchal rigidity
8. Changes in level of consciousness and mental
status
9. Signs of increased ICP
10. Motor dysfunction and focal neurological
deficits

7. Manangement
1. Monitor vital and neurological signs.
2. Assess level of consciousness using the Glasgow
Coma Scale.
3. Assess for mental status changes and personality
and behavior changes.
4. Assess for signs of increased ICP.
5. Assess for the presence of nuchal rigidity and a
positive Kernig’s sign or Brudzinski’s sign,
indicating meningeal irritation.

8. 6. Assist the client to turn, cough, and
deepbreathe frequently.
7. Elevate the head of the bed 30 to 45 degrees.
8. Assess for muscle and neurological deficits.
9. Administer acyclovir (Zovirax) as prescribed
(usually is the medication of choice for herpes
encephalitis).
10. Initiate rehabilitation as needed for motor
dysfunction or neurological deficits.