Post Encephalitic Syndrome
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This document discusses post-encephalitic psychiatric sequelae. Encephalitis is an inflammation of the brain that can be caused by viruses or bacteria. While some cases result in full recovery, others can lead to transient or persisting psychiatric symptoms. These post-encephalitic symptoms present in a variety of ways and can include conditions like organic personality disorder, post-encephalitic syndrome, and post-concussional syndrome. Specific viruses and infections like herpes simplex virus, Epstein-Barr virus, Japanese encephalitis, and influenza have all been linked to post-encephalitic psychiatric manifestations.
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1. What are the primary causes of meningitis?
What are the common manifestations associated with meningitis?
How does meningitis alter normal physiological function and cause each of the manifestations
that you listed above?
2. What are the primary causes of encephalitis?
What are the common manifestations associated with encephalitis?
How does encephalitis alter normal physiological function and cause each of the manifestations
that you listed above?
3. List the two primary causes of increased intracranial pressure.
Explain at least two mechanisms by which the increased intracranial pressure alters neural tissue
function.
Solution
Ans 1: Causes of meningitis: Meningitis is typically caused by an infection with microorganisms.
Viral infections are the most common cause of meningitis, followed by bacterial infections and,
rarely, fungal infections. Bacterial meningitis is generally a serious infection. It is caused by
three types of bacteria: Haemophilus influenzae type b, Neisseria meningitidis, and
Streptococcus pneumoniae bacteria.
Bacteria that enter the bloodstream and travel to the brain and spinal cord cause acute bacterial
meningitis. But it can also occur when bacteria directly invade the meninges. This may be caused
by an ear or sinus infection, a skull fracture, or, rarely, after some surgeries.
Several strains of bacteria can cause acute bacterial meningitis, most commonly:
Viral meningitis: Viral meningitis is usually mild and often clears on its own. Most cases in the
United States are caused by a group of viruses known as enteroviruses, which are most common
in late summer and early fall. Viruses such as herpes simplex virus, HIV, mumps, West Nile
virus and others also can cause viral meningitis.
Chronic meningitis: Slow-growing organisms (such as fungi and Mycobacterium tuberculosis)
that invade the membranes and fluid surrounding your brain cause chronic meningitis. Chronic
meningitis develops over two weeks or more. The symptoms of chronic meningitis —
headaches, fever, vomiting and mental cloudiness — are similar to those of acute meningitis.
Fungal meningitis: Fungal meningitis is relatively uncommon and causes chronic meningitis. It
may mimic acute bacterial meningitis. Fungal meningitis isn\'t contagious from person to person.
Cryptococcal meningitis is a common fungal form of the disease that affects people with immune
deficiencies, such as AIDS. It\'s life-threatening if not treated with an antifungal medication.
Other meningitis causes: Meningitis can also result from noninfectious causes, such as chemical
reactions, drug allergies, some types of cancer and inflammatory diseases such as sarcoidosis.
Common manifestations associated with meningitis are as follows: Bacterial meningitis
symptoms may develop within hours or days. Viral meningitis symptoms may also develop
quickly or over several days. These are common signs and symptoms of both types. Not all
symptoms may appea.
Neuropsychiatry [2017]
This document summarizes several common neurological disorders and their associated neuropsychiatric manifestations. It discusses neurosyphilis in a case report of a 56-year-old man presenting with rapid cognitive decline. It then discusses the neuropsychiatric manifestations of epilepsy, including prodromal symptoms, auras, postictal states, and interictal psychosis. Finally, it briefly touches on the neuropsychiatric symptoms seen in Parkinson's disease and post-stroke.
Schizophrenia
Schizophrenia is a significant mental disorder in which people interpret reality abnormally & it may result in some combination of hallucinations, delusions, and extremely disordered thinking and behavior that impairs daily functioning. Through this period Anti psychotic & Psycho social treatment improve the condition.
PERIPHERAL NEUROPATHY
I. The peripheral nervous system carries signals between the central nervous system and the rest of the body. It has three main components - cranial, spinal, and autonomic. There are three main types of nerve fibers - A, B, and C - which differ in diameter, myelination, and function.
II. Peripheral neuropathies can be acquired through systemic diseases, trauma, infections, or inherited genetically. Common acquired neuropathies include diabetic neuropathy, Guillain-Barré syndrome, chronic inflammatory demyelinating polyneuropathy, and alcoholic neuropathy. Inherited forms include Charcot-Marie-Tooth disease and hereditary liability to pressure palsies.
Dr Nivedita Bajaj - Basic Facts About Childhood Epilepsy
The basics Epilepsy by Dr Nivedita Bajaj , She is a Consultant Paediatrician working within NHS, currently employed by East and North Herts NHS Trust. Dr Bajaj has extensive experience in assessment and management of a wide range of neurodevelopmental conditions and neurodiabilities. She leads clinical autism service in her trust.
Visit - https://drniveditabajaj.blogspot.co.uk/
For more - https://www.nhs.uk/profiles/consultant/6068845
Read More - https://about.me/drniveditabajaj
Poliomyelitis
A spinal injury can be very serious if it results in paralysis or damage to the spinal cord. For example, a broken neck that severs the connection between the brain and parts of the body below the injury site can cause quadriplegia or paraplegia depending on the level of the break. Damage to the spinal cord often has permanent consequences because nerves in the spinal cord do not regenerate easily.
INFECTION OF THE BRAIN -ENCEPHALITIS ( PPT)
Neurological system includes brain and spinal cord. It plays an important role in functioning of our body. Encephalitis is the inflammation of the brain. Causes include viral infections, infections from insect bites or an autoimmune reaction that affects the brain. It can be life-threatening or cause long-term complications. Treatment varies, but most people require hospitalization so they can receive intensive treatment, including life support.
EPILEPSY.pdf
This document provides information about epilepsy and its management. It defines epilepsy as a chronic condition characterized by recurrent seizures. Seizures occur due to abnormal electrical activity in the brain. The goals of drug treatment are to restore normal brain electrical patterns and control seizures. Several anti-epileptic drugs are discussed that work via different mechanisms such as decreasing sodium influx or increasing GABA activity. Common anti-epileptic medications mentioned include phenytoin, carbamazepine, and valproic acid.
Epilepsy.pdf neurology education information
Epilepsy is defined as recurrent seizures caused by excessive electrical discharges in the brain. It affects people of all ages worldwide. The causes of epilepsy can include genetic factors, structural abnormalities, metabolic disorders, infections, or unknown causes. Seizures occur due to an imbalance between excitatory and inhibitory signals in the brain. Epilepsy is diagnosed based on having two or more unprovoked seizures or one seizure with a high risk of future seizures. Seizures can vary in their clinical presentation depending on the area of brain involved.
Neurological complications of hiv
HIV or human immunodeficiency virus causes the infection that progresses to AIDS (acquired immunodeficiency syndrome). It weakens the immune system and slowly destroys most of the CD4 cells (cells that fight infections) in the body.
Neuropsychiatric aspects of epilepsy
This document provides an overview of the history, definitions, classification, epidemiology and psychiatric disorders associated with epilepsy. It discusses how epilepsy was viewed in ancient times as a supernatural condition and outlines key developments in understanding including Hippocrates' view of it as a brain disorder. It defines terms like seizure, aura and epilepsy and classifies seizure types. Statistics on prevalence and risk factors for psychopathology in epilepsy are presented. Specific psychiatric conditions like depression, anxiety and inter-ictal psychosis are also examined.
Syphilis and Neurosyphilis 101
The document discusses various stages and types of syphilis including neurosyphilis. It describes the typical early manifestations of congenital syphilis in infants as well as the four clinical types of neurosyphilis - asymptomatic neurosyphilis, meningovascular syphilis, general paresis, and tabes dorsalis. General paresis is a chronic dementia that results in death within 2-3 years and is characterized by personality changes, memory loss, and poor judgment. Tabes dorsalis affects the spinal cord and can cause an unsteady gait and sensory issues. Diagnosis of neurosyphilis involves lumbar puncture, CSF analysis, and various imaging and blood tests. Treatment is with pen
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June 14, 2024Breast cancer: Post menopausal endocrine therapy
Breast cancer in postmenopausal women with hormone receptor-positive (HR+) status is a common and complex condition that necessitates a multifaceted approach to management. HR+ breast cancer means that the cancer cells grow in response to hormones such as estrogen and progesterone. This subtype is prevalent among postmenopausal women and typically exhibits a more indolent course compared to other forms of breast cancer, which allows for a variety of treatment options.
Diagnosis and Staging
The diagnosis of HR+ breast cancer begins with clinical evaluation, imaging, and biopsy. Imaging modalities such as mammography, ultrasound, and MRI help in assessing the extent of the disease. Histopathological examination and immunohistochemical staining of the biopsy sample confirm the diagnosis and hormone receptor status by identifying the presence of estrogen receptors (ER) and progesterone receptors (PR) on the tumor cells.
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Treatment Options
Endocrine Therapy
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Selective Estrogen Receptor Modulators (SERMs): Tamoxifen is a SERM that binds to estrogen receptors, blocking estrogen from stimulating breast cancer cells. It is effective but may have side effects such as increased risk of endometrial cancer and thromboembolic events.
Aromatase Inhibitors (AIs): These drugs, including anastrozole, letrozole, and exemestane, lower estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogen in peripheral tissues. AIs are generally preferred in postmenopausal women due to their efficacy and safety profile compared to tamoxifen.
Selective Estrogen Receptor Downregulators (SERDs): Fulvestrant is a SERD that degrades estrogen receptors and is used in cases where resistance to other endocrine therapies develops.
Combination Therapies
Combining endocrine therapy with other treatments enhances efficacy. Examples include:
Endocrine Therapy with CDK4/6 Inhibitors: Palbociclib, ribociclib, and abemaciclib are CDK4/6 inhibitors that, when combined with endocrine therapy, significantly improve progression-free survival in advanced HR+ breast cancer.
Endocrine Therapy with mTOR Inhibitors: Everolimus, an mTOR inhibitor, can be added to endocrine therapy for patients who have developed resistance to aromatase inhibitors.
Chemotherapy
Chemotherapy is generally reserved for patients with high-risk features, such as large tumor size, high-grade histology, or extensive lymph node involvement. Regimens often include anthracyclines and taxanes.
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