Encephalitis is inflammation of the brain primarily caused by viral infections, with Herpes simplex virus being the most common, along with other viral pathogens. Symptoms can develop rapidly and include fever, neurological deficits, and altered consciousness; diagnosis typically involves lumbar puncture and imaging studies. Management focuses on differentiating from other conditions and may include antiviral treatments, antipyrtics, and corticosteroids.

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ENCEPHALITIS

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INTRODUCTION
Encephalitis is an inflammation of the brain parenchyma that is
caused by infection with virus of less common by bacterial or
fungal infection or autoimmune reaction.

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ETIOLOGY
The exact cause of encephalitis is still unknown, but when the cause is known
the most common cause is viral infection.
Common organism are Herpes Simplex virus 1 & 2, Epsteir Barr Virus,
Entrovirus, Mosqutio Borne Virus like West Nile, Tick Borne Virus, Rabis Virus,
Rubeola, Arbovirus.
Other cause are CVA, Immune Compromised and Upper respiratory Tract
Infection.
Non causative factors are autoimmune, vasculitis, neoplastic.

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PATHOPHYSIOLOGY
MICROBIAL INVASION
Cross the BBB/ Direct Entry
Microbial growth and multiplies in
the cerebral tissue
Inflammation in Brain Parenchyma &
Neuronal Cells
Local Necrotizing hemorrhage the
become generalized
Edema & Increased ICP
Progressive deteoriation of
NerveTissue

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SIGN & SYMPTOMS
• Symptoms may develop within hours or week after exposure.
• The main Symptom is Fever >380
C within 72hrs or after presentation.
• Headache, Disorientation, Neurological Defects
• Seizures, Increased ICP may result in altered consciousness
• Nausea and Vomiting.
• Motor weakness such as Hemiparesis may be seen.
• Increased Deep Tendon Reflex and Extensor Plantar responses noted.
• Hypothalamic Pituitary involvement may result in Hypothermia, Diabetes etc.

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• Neuroligical Symptoms Includes
Superior Quadrant Visual Field Defects
Aphasia, Dysphagia, Ataxia & Paresthesia
Nystagmus
Hearing Loss

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DIAGNOSTIC EVALUATIONS
• Lumbar Puncture with evaluation of CSF if Performed to detect Leukocytes, & Increased
Proteins.
• PCR for Analysis of the virus DNA and Detection of Intrathecally produced viral Antibodies
• ECG may demonstrate slow brain waves complex
• MRI differentiates Post Infection Encephalomyelities from acute viral encephalitis.
• Brain Tissue Biopsy indicated the presence of Organism

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MANAGEMENT
• Differentiate acute viral encephalitis from non infectious disease like
Sarcoidosis, SLE etc.
• In Patient with immune compromised like HIV, differentiate acute viral
encephalitis from cytomegalovirus encephalitis, toxoplasmic encephalitis.
• Patient with Cytomegalovirus may be treated with Ganciclovir & Foscarnet.
• Patient with Toxoplasma encephilities nay be treated with Daraprim &
Sulpadoxine.
• Patient with Herpes Simplex can be treated with IV Acyclovir for 10-2 days. And
mother who have genital herpes simplex may be treated with acyclovir during 3rd
Trimester to avoid transportation of virus from mother to child during delivery.

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• Antipyrtics to reduce fever.
• Antibiotic therapy same as Menangities can be adopted.
• Corticosteriods can be administrated.
• Craniotomy to reduce Intracranial Pressure.

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