Infective Encephalitis
Overview
Overview Encephalitis, inflammation of the brain parenchyma, can be caused by either an infection or autoimmune process. Clinical features of encephalitis include fever, altered mental status, neurological deficit and seizures. Definitive diagnosis rests on a lumbar puncture with CSF examination. Encephalitis can be difficult to distinguish from meningitis. Young, old and especially those who are immunocompromised are susceptible to developing encephalitis.
Encephalitis | Meningitis | |
Signs and symptoms
- Meninges involvement
- Neck stiffness
- Photophobia
- Altered level of consciousness
- Hallucination
- Personality changes
- Seizures
- Focal neurological disturbance
- aphasia
- ataxia
- upper motor neuron weakness
- lower motor neuron weakness
- cranial nerve palsy
Differential Diagnosis
Investigations
- FBC
- EUC
- LFT
- CMP
- VBG
- Blood cultures
- Urinalysis
- Electroencephalogram
- CT brain
- MRI brain
- Lumbar puncture with CSF examination
Aetiology
Herpesviruses
- Herpes Simplex Virus
- Ebstein Barr Virus
- Varicella Zoster Virus
Arthropod-bourne viruses
- Japanese encephalitis
- West Nile Virus
Enteroviruses
Pathophysiology
Complications and Prognosis
Complications
Prognosis
80% of patients will have severe neurologic sequelae