Encephalitis is an inflammation of the brain. Most often, the disease occurs due to one of the viruses (herpes virus, measles, and others), as well as viruses that are transmitted by mosquitoes or ticks through bites. Inflammations of the brain are of different types: infectious, infectious-allergic, allergic, toxic. Encephalitis can be accompanied by flu-like symptoms, such as a high fever or severe headache, as well as confusion, seizures, or problems with perception or control of movement. Usually, the causes of encephalitis are infectious factors: viruses, bacteria, protozoa, fungi, and the like.
In primary encephalitis, the virus directly affects the brain and spinal cord. A secondary form of encephalitis occurs when the virus infects any part of the body or organ other than the brain. The virus usually causes inflammation of the nerve cells (encephalitis) or the lining of the brain (meningitis). In most cases of severe encephalitis, the patient dies. But if this disease is diagnosed and treated in time, it can be completely cured.
In many patients, the course of encephalitis can be asymptomatic or be characterized by the following mild flu symptoms:
- elevated temperature;
- muscle and joint pain;
- fatigue or weakness.
More serious cases require immediate medical attention. Symptoms of a severe course of the disease:
- strong headache;
- elevated temperature;
- altered consciousness;
- confusion or excitement;
- personality change;
- loss of sensitivity or paralysis of certain areas of the body;
- muscle weakness;
- feeling unpleasant odors;
- speech or hearing problems;
- loss of consciousness.
Symptoms of encephalitis in infants and young children may also include:
- bloating fontanelle in infants;
- nausea and vomiting;
- spasms, body stiffness ;
- constant crying;
- increased crying if the child is taken in your arms;
- lack of appetite.
The causes of encephalitis
It is often impossible to establish the cause of encephalitis, but in most cases, it is a viral infection. The most common causes of this disease are:
Infection can lead to the development of one of two pathological conditions affecting the brain:
- Primary encephalitis occurs when a virus or other infectious agent enters the brain directly and infects it. The infection can be concentrated in one area or completely cover an organ. Primary infection can result from the reactivation of a latent virus after an illness.
- Secondary (post-infectious) encephalitis is a pathological reaction of the immune system in response to an infection in the body. Most often, secondary encephalitis develops when infection-fighting proteins mistakenly attack brain cells. Secondary encephalitis usually occurs two to three weeks after the initial infection. In rare cases, secondary encephalitis develops as a complication after vaccination against viral infections.
Diagnosis of encephalitis
In order to make a diagnosis of encephalitis, it is important to induce symptoms, risk factors, and medical history. The following diagnostic procedures may be required:
- Brain tomography. Very often, a brain tomography is the first diagnostic procedure performed by a doctor if symptoms and history indicate a possible development of encephalitis. Tomography can show swelling or other causes of these symptoms, such as tumors. Diagnostics include magnetic resonance imaging, which provides detailed images and 3D or computed tomography.
- Lumbar puncture. During a lumbar puncture, the doctor inserts a needle into the lower back and receives the cerebrospinal fluid that surrounds the spinal cord and spine. A certain structure of blood cells and proteins of the immune system indicates the presence of infection and inflammation in the brain. In some cases, samples of cerebrospinal fluid are examined in a laboratory to look for the virus that causes the disease or other infectious agents.
- Other laboratory tests. Your doctor may need results from blood, urine, or throat swabs. All tests are laboratory tested to identify viruses or other infectious agents that cause encephalitis.
- Electroencephalogram. Your doctor may order an electroencephalogram, a procedure in which multiple electrodes are attached to the scalp. EEG records the electrical activity of the brain. Certain deviations may indicate the development of encephalitis.
- Brain biopsy. In very rare cases, a brain biopsy is done – a procedure in which a small sample of brain tissue is removed (biopsy). This procedure is prescribed in the event that the patient’s health condition deteriorates, the selected treatment does not give an effect, and there is no way to make a correct diagnosis.
Varieties of viral encephalitis
Viruses carried by insects are called arboviruses. They are most often found in medical practice. Mosquito-borne arboviruses include:
- Eastern equine encephalitis. The disease is rare; no more than a few people worldwide are infected with it annually. 50% of those infected dies because the brain damage is irreversible;
- Encephalitis of “La Crosse”. Typical for children and adolescents under 16 living in the Western United States. Fatalities are rare;
- Encephalitis “St. Louis”. Named after the American of the same name, it is found in the south and west of the United States among the population living in rural areas. Differs in severe symptoms, especially in people over 60;
- Encephalitis of “West Nile”. It affects people in Africa and the Middle East. Occasionally found in the United States. The disease is especially dangerous for children and the elderly, mortality is very high;
- Western equine encephalitis. The infection is common in the United States and Canada. The disease proceeds under the guise of ordinary flu or ARVI, but if it is not recognized in time, the brain damage can become irreversible.
Risk factors for encephalitis
No one is immune from encephalitis. Factors that increase your risk of developing the disease include:
- Age. Some types of encephalitis are more common and more severe in certain age groups. In general, young children and the elderly are at greater risk of contracting viral encephalitis. Herpes simplex encephalitis is more common in people between the ages of 20 and 40.
- Weakened immune system. At high risk are people with HIV / AIDS who are taking medications that suppress the immune system or have other medical conditions that weaken the immune system.
- Some regions. Mosquito-borne viruses and tick-borne viruses are more common in certain geographic regions.
- Outdoor activities. Transmitted by mosquitoes or ticks, they increase the risk of developing viral diseases.
- Seasonality. Diseases transmitted by mosquitoes or ticks are most common in the summer and early fall.
The first thing that a patient receives with infectious encephalitis is antiviral drugs, elimination of the root cause of the disease. These include antibiotics, acyclovir, and immunomodulatory drugs. It is necessary to eliminate the symptoms and consequences of the disease – to try to return the body to normal functioning.
It is necessary to support the person psychologically and create a comfortable environment for him. Due to his increased sensitivity, it is better to minimize contacts and visits, reduce noise levels, provide a calm and comfortable environment and treat unusual and sometimes aggressive behavior with care and understanding. It is necessary to consult with specialists in time and do not hesitate to ask for help from close people.
Whatever form of encephalitis a person has, it is very important to create an environment for the natural healing process. In addition to a favorable environment, the help of rehabilitation specialists is essential for a person, since the disease affects cognitive, behavioral, social, emotional, and medical aspects. It is crucial in all respects to support the patient and his family.
During rehabilitation, it is vital to consider psychological and physical support:
- try to regain cognitive skills,
- work with motivation and emotional state,
- develop physical and mental stamina,
- improve the quality of life,
- develop social skills.
You can discuss with your doctor the rehabilitation program and the profile of the specialists you need to involve. Usually, recovery procedures after encephalitis are carried out by a neurologist, psychologist and neuropsychologist, speech therapist, physiotherapist, and occupational therapist. Together they will restore body functions.