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Encephalitis

From Mediwikis
CT scan Rasmussen's encephalitis.png

This medical emergency is inflammation of the brain tissue itself (not the meningeal covering, as in Meningitis)

Causes

Viral

Most commonly:

  • Herpes Simplex 1+2

More rarely:

  • Rabies virus, Polio, Measles

Bacterial

Secondary to systemic infection, or local meningeal infection.

  • Syphilis

In immunocompromised:

  • Toxoplasmosis
  • Malaria

Symptoms & Signs

Similar to Meningitis, but note the following:

  • Strange behaviour/ confusion
  • Reduced GCS
  • Fever
  • Headache
  • Focal neurology
  • Seizures

Investigations

  • Blood cultures
  • Viral PCR
  • Contrast CT
  • LP (only after CT shows normal ICP)

Management

  • Aciclovir
  • HDU/ ITU management
  • Manage symptoms e.g. calm environment for confusion, phenytoin for seizures.