The document presents a seminar on encephalitis, defining it as inflammation of the brain and describing its main types, causes, symptoms, diagnostic tests, treatment including pharmacological and nursing management, complications, and prevention methods. Encephalitis is usually caused by a viral infection but can also be caused by bacteria, and symptoms may include fever, headache, nausea, and confusion.

1. Salale University
College of Health Sciences
Department of Adult Health Nursing
Seminar Presentation on: ENCEPHALITIS
Presented by : Kedir Mohammed ID : 182/15
Presented to : Bikila (Assistant professor)
OCT 3/05/ 2023
Fiche

2. CONTENTS
• Definitions
• Etiology
• Pathophysiology
• Clinical Manifestations
• Investigations
• Treatment
• Nursing Management
• Complications
• Summary
• Reference

3. OBJECTIVE
• To introduce & define the topic
• To explain types of encephalitis
• To enlist risk factors & etiology
• To explain clinical manifestation & diagnostic evaluatio
n
• To explain medical & nursing management and prevent
ion of encephalitis.

4. ENCEPHALITIS
• Encephalitis is a rare yet serious disease that can be life-
threatening.
• Encephalitis is the inflammation of the brain parenchym
a.
• Encephalitis with meningitis is known as meningoencep
halitis.
• Encephalitis can be infectious or noninfectious and ac
ute, subacute,or chronic.

5. ENCEPHALITIS
TYPES
• There are two main types of encephalitis:
• Primary encephalitis- It occurs when a virus directly
infects the brain and spinal cord.
• Secondary encephalitis- It occurs when an infection s
tarts elsewhere in the body and then travels to your bra
in. Results from a faulty immune system reaction.
EPIDEMIOLOGY
• A rare disease
• Most common in children , elderly, and people with w
eakened immune systems (HIV/AIDS or cancer).

6. Etiology
• The cause of encephalitis is usually infectious.
• is viral infections.
• Viral Causes: The most common cause
 Enteroviruses (it is the most common cause of the viral
infection)
 HSV-1, Arboviruses, Adenoviruses, Rabies, Measles,
Mumps virus
• Bacteria -Mycoplasma, Toxoplasmosis , malaria , prim
ary amoebic meningoencephalitis.
• Fungus
• Immunosuppressed
• Upper respiratory infections

7. Risk Factors
• Anyone can develop encephalitis
• Factors that may increase the risk include:
 Older adults
 Children under the age of 1 year
 People with weak immune systems
 Geographical regions. Mosquito- or tick-borne virus
es are common in particular geographical regions.
 Season of the year. Mosquito- and tick-borne diseases
tend to be more common in summer in many areas of t
he United States.

8. PATHOLOGY

9. SIGN And SYMPTOMS
• Fever with hallucinations
• Headache – may be severe with double vision
• Nausea & Vomiting
• Raised ICP- Stiff neck, pupils, motor weakness
• Confusion, personality changes, convulsions
• Poor appetite
• Loss of energy
• problems with memory
• speech problems
• Seizures are common at presentation

10. SIGN And SYMPTOMS
• The specific prodrome in encephalitis caused by (herpe
sviruses ) such as varicella-zoster virus, Epstein-Barr vi
rus or cytomegalovirus, and measles or mumps viruses i
ncludes :
 lymphadenopathy, hepatosplenomegaly, and parotid enl
argement.

11. Widespread edema and subarachnoid hem
orrhage areas in medial temporal and orbit
ofrontal regions

12. DIAGNOSIS
• Signs & Symptoms
 Neurological examinations reveal a drowsy or con
fused patient.
 Stiff neck ,may indicate meningoncephalitis.
• CT/MRI - to check for cerebral swelling of the p
arenchyma or focal abnormalities in temporal lobe
.
• EEG – Is the definitive test and shows abnormal b
rain waves ( spike and slow wave activity) from th
e temporal lobe.
• Blood test - Confirm presence of bacteria/viruses i
n cerebrospinal fluid and antibodies to fight infecti
on

13. DIAGNOSIS
• LP Analysis of CSF - increased amounts of protei
n and white blood cells (mainly lymphocytes) with
normal glucose levels
• PCR - it is the best choice when you suspect herp
es simplex infection)
• BRAIN BIOBSY - Rare

14. TREATMENT
• Early therapy is a critical factor in outcome
• People with severe symptoms are likely to need tre
atment in an intensive care unit (ICU) admission.

15. TREATMENT
PHARMACOLOGICAL MANAGEMENT
• Anti-inflammatory drugs & antipyretics - aceta
minophen (Tylenol, others), ibuprofen (Advil, Mo
trin IB, others) and naproxen sodium (Aleve) — t
o relieve headaches and fever
• Pyrimethamine (Daraprim) and sulfadoxine (Fa
nsidar) are commonly used to treat Toxoplasma en
cephalitis.

16. TREATMENT
• Mannitol or glycerol may be needed to reduce I
CP.
• Antibiotics
• Vitamin and mineral supplementation
• IV fluid therapy and dopamine to be given to tre
at shock and fluid electrolyte imbalance.
• Anticonvulsive drugs

17. TREATMENT
• Corticosteroids are used to reduce brain swelling
and inflammation (Reduce ICP and to suppress the
activity of their immune system.
• Sedatives may be needed for irritability or restless
ness.
• Antiviral drugs - Acyclovir (Zovirax) Ganciclovi
r (Cytovene)
• Acyclovir - Iv injection is the treatment of choice
(for 14 days). When the diagnosis of HSE is suspe
cted or has been established.

18. TREATMENT
NON- PHARMACOLOGICAL MANAGEMENT
• close monitoring (neuro obs, vital signs & body fl
uids to prevent further swelling
• Oxygenation to be provided by nasal cannula
• Mechanical ventilation is necessary in cardio-respi
ratory insufficiency
• Timely detection of electrolyte abnormalities
• position -Reduce ICP

19. NURSING MANAGEMENT
1. ASSESSMENT
• Obtain a history of recent infections such as upper respir
atory infection, and exposure to causative agents.
• Assess neurologic status and vital signs.
• Evaluate for signs of meningeal irritation.
• Assess sensorineural hearing loss (vision and hearing), c
ranial nerve damage (eg, facial nerve palsy), and diminis
hed cognitive function.

20. NURSING MANAGEMENT
2. Nursing Diagnosis
• Ineffective Tissue Perfusion (cerebral) related to infecti
ous process and cerebral edema
• Risk for Imbalanced Fluid Volume related to fever and
decreased intake
• Hyperthermia related to the infectious process and cere
bral edema.
• Acute Pain related to meningeal irritation
• Impaired Physical Mobility related to prolonged bed re
st.

21. NURSING MANAGEMENT
3. Goal
• To Enhanced Cerebral Tissue Perfusion
• To Maintain Fluid Balance
• To Reduce Fever
• To Reduce Pain
• To Return to Optimal Level of Functioning/ mobility

22. NURSING MANAGEMENT
4. Intervention
• Enhancing Cerebral Perfusion
 Assess LOC, vital signs, and neurologic parameters freq
uently. Observe for signs and symptoms of ICP
 Maintain a quiet, calm environment to prevent agitation,
which may cause an increased ICP.
• Maintaining Fluid Balance
 Prevent I.V. fluid overload, which may worsen cerebral
edema.
 Monitor intake and output closely.

23. NURSING MANAGEMENT
• Reducing Fever
 Administer antimicrobial agents on time to maintain o
ptimal blood levels.
 Monitor temperature frequently or continuously, and ad
minister antipyretics as ordered.
• Promoting Return to Optimal Level of Functioning
 Implement rehabilitation interventions after admission (
eg, turning, positioning).
 Progress from passive to active exercises based on the
patient's neurologic status.

24. NURSING MANAGEMENT
• Reducing Pain
 Administer analgesics as ordered; monitor for response
and adverse reactions.
 Avoid opioids, which may mask a decreasing LOC.
 Darken the room if photophobia is present.
 Assist with position of comfort for neck stiffness, and tu
rn patient slowly and carefully with head and neck in ali
gnment.
 Elevate the head of the bed to decrease ICP and reduce
pain.

25. NURSING MANAGEMENT
5. EXPECTED OUTCOMES
 Enhanced Cerebral Tissue Perfusion
 Reduced Fever
 Fluid Balance Maintained
 Reduced Pain
 Return to Optimal Level of Functioning

26. COMPLICATIONS
• Most people make a full recovery
• Infants younger than 1 year and adults over 55 are at grea
test risk of death
• Herpes encephalitis is usually fatal if no anti viral drugs u
sed

27. PREVENTION
• Practice good hygiene.
• Don't share utensils.
• Get vaccinations.
• Protection against mosquitoes and ticks
• Dress to protect yourself.
• Apply mosquito repellent.
• Use insecticide.
• Avoid mosquitoes.
• Get rid of water sources outside your home.

28. SUMMARY
• Encephalitis is an inflammation of the brain.
Usually the cause is a viral infection, but ba
cteria can also cause it. It can be mild or sev
ere.
• Most cases are mild. People may have flu-li
ke symptoms.

29. REFERENCE
• Boyer Jo Mary(2004), Textbook Of Medical Surgi
cal Nursing, Philadelphia, Lippincott William &
Wilkins.
• Lewis Mantik Sharon et. Al. (2000), Medical Surg
ical Nursing, Assessment & Management Of Clini
cal Problems, St. Louis, Missouri, Mosby Publishe
rs.
• Lippincott (2001), Manual of Nursing Practice, J.P
. Brothers,Philadelphia.