Encephalitis

Encephalitis (from Ancient Greek ,

enkphalos brain,[1] composed of , en, in and
, kephal, head, and the medical sux
-itis inammation) is an acute inammation of the
brain.[2] Encephalitis with meningitis is known as
meningoencephalitis.
Symptoms include headache,
fever, confusion, drowsiness, and fatigue. Further
symptoms include seizures or convulsions, tremors,
hallucinations, stroke, and memory problems.[3] In 2013,
encephalitis was estimated to have resulted in 77,000
deaths, down from 92,000 in 1990.[4]

Signs and symptoms

Adult patients with encephalitis present with acute onset

of fever, headache, confusion, and sometimes seizures.
Younger children or infants may present irritability, poor
appetite and fever.[5] Neurological examinations usually reveal a drowsy or confused patient. Sti neck,
due to the irritation of the meninges covering the
brain, indicates that the patient has either meningitis or
meningoencephalitis.[6]
Rabies Virus

Cause

with compromised immune systems. Lyme disease

and/or Bartonella henselae may also cause encephalitis. Other bacterial pathogens, like Mycoplasma and
Main article: Viral encephalitis
those causing rickettsial disease, cause inammation of
Viral encephalitis can occur either as a direct eect the meninges and consequently encephalitis. A nonof an acute infection, or as one of the sequelae of a infectious cause includes acute disseminated encephalitis
latent infection. The most common causes of acute viral which is demyelinated.[11]
encephalitis are rabies virus, HSV infection, poliovirus,
and measles virus.[7] Other possible viral causes are arbovirus (St. Louis encephalitis, West Nile encephalitis
virus), bunyavirus (La Crosse strain), arenavirus (lymphocytic choriomeningitis virus) and reovirus (Colorado
tick virus)[8]
2.3 Limbic encephalitis

2.1

Viral

2.2

Bacterial and other

Limbic encephalitis refers to inammatory disease conned to the limbic system of the brain. The clinical
presentation often includes disorientation, disinhibition,
memory loss, seizures, and behavioral anomalies. MRI
imaging reveals T2 hyperintensity in the structures of the
medial temporal lobes, and in some cases, other limbic
structures. Some cases of limbic encephalitis are of autoimmune origin.[12]

It can be caused by a bacterial infection, such as bacterial meningitis,[9] or may be a complication of a current
infectious disease syphilis (secondary encephalitis).[10]
Certain parasitic or protozoal infestations, such as
toxoplasmosis, malaria, or primary amoebic meningoencephalitis, can also cause encephalitis in people
1

7 SEE ALSO

2.4

Autoimmune encephalitis

Main article: Autoimmune encephalitis

Autoimmune encephalitis signs can include catatonia,
psychosis, abnormal movements, and autonomic dysregulation. Antibody-mediated anti-N-methyl-D-aspartatereceptor encephalitis and Rasmussen encephalitis are examples of autoimmune encephalitis.[13]

4 Treatment
Treatment (which is based on supportive care) is as
follows:[16]
Antiviral medications (if virus is cause)
Antibiotics, (if bacteria is cause)
Steroids are used to reduce brain swell

2.5

Encephalitis lethargica

Sedatives for restlessness

Main article: Encephalitis lethargica

Acetaminophen for fever

Encephalitis lethargica is identied by high fever,

headache, delayed physical response, and lethargy. Individuals can exhibit upper body weakness, muscular pains,
and tremors, though the cause of encephalitis lethargica
is not currently known. From 1917 to 1928, an epidemic
of encephalitis lethargica occurred worldwide.[14]

Physical therapy (if brain is aected post-infection)

Diagnosis

5 Prevention
Vaccination is available against tick-borne[17] and
Japanese encephalitis[18] and should be considered for
at-risk individuals. Post-infectious encephalomyelitis
complicating smallpox vaccination is avoidable as smallpox is now eradicated. Contraindication to Pertussis
immunisation should be observed in patients with
encephalitis.[19]

6 Epidemiology
The incidence of acute encephalitis in Western countries
is 7.4 cases per 100,000 population per year. In tropical
countries, the incidence is 6.34 per 100,000 per year.[20]
In 2013 encephalitis was estimated to have resulted in
77,000 deaths, down from 92,000 in 1990.[4] Herpes simplex encephalitis has an incidence of 24 per million population per year.[21]
Spinal tap

Diagnosing encephalitis is done via a variety of tests:[15]

Brain scan, done by MRI, can determine inammation and dierentiate from other possible causes.
EEG, in monitoring brain activity, encephalitis will
produce abnormal signal.

7 See also
Rasmussens encephalitis
Bickerstas encephalitis
La Crosse encephalitis

Lumbar puncture (spinal tap), this helps determine

via a test using the cerebral-spinal uid, obtained
from the lumbar region.

Wernickes encephalopathy

Blood test

Cerebritis

Urine analysis

Encephalomyelitis

Meningitis

References

[16] Encephalitis: MedlinePlus Medical Encyclopedia.

www.nlm.nih.gov. Retrieved 2015-08-05.

[1] Woodhouses English-Greek Dictionary (in German).

The University of Chicago Library. Retrieved 2013-0110.

[17] Tick-borne Encephalitis. Retrieved 2 April 2013.

[2] encephalitis.

[19] CDC - Vaccines - Contraindications and Precautions to

Commonly Used Vaccines in Adults. www.cdc.gov. Retrieved 2015-08-05.

[3] Meningitis and Encephalitis Fact Sheet: National Institute of Neurological Disorders and Stroke (NINDS)".
www.ninds.nih.gov. Retrieved 2015-08-05.
[4] GBD 2013 Mortality and Causes of Death, Collaborators (17 December 2014). Global, regional, and national
age-sex specic all-cause and cause-specic mortality for
240 causes of death, 1990-2013: a systematic analysis for
the Global Burden of Disease Study 2013.. Lancet 385
(9963): 11771. doi:10.1016/S0140-6736(14)61682-2.
PMC 4340604. PMID 25530442.
[5] Symptoms of encephalitis. NHS. Retrieved 5 January
2015.
[6] Shmaefsky, Brian; Babcock, Hilary (2010-01-01).
Meningitis. Infobase Publishing. ISBN 9781438132167.
[7] Fisher, D. L.; Defres, S.; Solomon, T. (2015). Measlesinduced encephalitis.
QJM 108 (3): 177182.
doi:10.1093/qjmed/hcu113. PMID 24865261.
[8] Kennedy, P. G. E. (2004-03-01). Viral Encephalitis:
Causes, Dierential Diagnosis, and Management. Journal of Neurology, Neurosurgery & Psychiatry 75 (suppl 1):
i10i15. doi:10.1136/jnnp.2003.034280. ISSN 1468330X. PMC 1765650. PMID 14978145.
[9] Ashar, Bimal H.; Miller, Redonda G.; Sisson, Stephen
D. (2012-01-01). Johns Hopkins Internal Medicine Board
Review: Certication and Recertication. Elsevier Health
Sciences. ISBN 1455706922.
[10] Hama, Kiwa; Ishiguchi, Hiroshi; Tuji, Tomikimi;
Miwa, Hideto; Kondo, Tomoyoshi (2008-01-01).
Neurosyphilis with Mesiotemporal Magnetic Resonance
Imaging Abnormalities. Internal Medicine 47 (20):
18131817. doi:10.2169/internalmedicine.47.0983.
[11] Encephalitis: Practice Essentials, Background, Pathophysiology.
[12] Larner, A. J. (2013-05-02). Neuropsychological Neurology: The Neurocognitive Impairments of Neurological Disorders. Cambridge University Press. ISBN
9781107607606.
[13] Armangue, Thas; Petit-Pedrol, Mar; Dalmau, Josep
Autoimmune Encephalitis in Chil(2012-11-01).
dren. Journal of child neurology 27 (11): 1460
1469. doi:10.1177/0883073812448838. ISSN 08830738. PMC 3705178. PMID 22935553.
[14] Encephalitis Lethargica Information Page: National Institute of Neurological Disorders and Stroke (NINDS)".
www.ninds.nih.gov. Retrieved 2015-08-05.
[15] Encephalitis - Diagnosis - NHS Choices. www.nhs.uk.
Retrieved 2015-08-05.

[18] Japanese encephalitis. Retrieved 2 April 2013.

[20] Jmor, F; Emsley HC, Fischer M; et al. (October 2008).

The incidence of acute encephalitis syndrome in Western industrialised and tropical countries (PDF). Virology
Journal 5 (134): 134. doi:10.1186/1743-422X-5-134.
PMC 2583971. PMID 18973679.
[21] Rozenberg, F; Deback C; Agut H (June 2011). Herpes simplex encephalitis: from virus to therapy. Infectious Disorders Drug Targets 11 (3): 235250.
doi:10.2174/187152611795768088. PMID 21488834.

9 Further reading
Information, National Center for Biotechnology; Pike, U. S. National Library of Medicine
8600 Rockville; MD, Bethesda; Usa, 20894.
Encephalitis - National Library of Medicine.
PubMed Health. Retrieved 2015-08-05.
AccessMedicine
|
Content.
accessmedicine.mhmedical.com.
Retrieved 201508-05.

10 External links
The Encephalitis Society - A Global resource on Encephalitis
Autoimmune Encephalitis Alliance
WHO: Viral Encephalitis
Encephalitis Global Inc. - A USA charity sharing
information and support
Encephalitis suerer on YouTube

11

11
11.1

TEXT AND IMAGE SOURCES, CONTRIBUTORS, AND LICENSES

Text and image sources, contributors, and licenses

Text

Encephalitis Source: https://en.wikipedia.org/wiki/Encephalitis?oldid=709906489 Contributors: The Epopt, Andre Engels, Deb, Azhyd,
David Martland, Angela, Marteau, Robbot, Giftlite, Zigger, Alison, Jfdwol, Pgan002, Pyle, Srittau, Adashiel, Rich Farmbrough, Harriv,
Pt, Bobo192, Stesmo, Smalljim, Shenme, Arcadian, Joe Jarvis, MPerel, Hagerman, John Stck, Alansohn, Wouterstomp, Axl, Cdc, Melaen,
Mikeo, Bsadowski1, Versageek, Bacteria, Danreitz, 2004-12-29T22:45Z, LOL, Pinball22, WadeSimMiser, Rickjpelleg, Isnow, Eras-mus,
Dysepsion, Siqbal, Graham87, Mendaliv, Rjwilmsi, Nneonneo, Supreme geek overlord, Nihiltres, Chobot, Wendystation, YurikBot, Briaboru, Polyvios, Grafen, Lexicon, Varun dt, Supten, Kyle Barbour, 21655, Zzuuzz, Dontaskme, Kopoltra, RG2, Federalist51, Blue520,
Eskimbot, Chongvictor, Amiyashrivastava, Gilliam, Keegan, RDBrown, Green meklar, Al Pereira, DHN-bot~enwiki, Can't sleep, clown
will eat me, Snowmanradio, Rrburke, Parent5446, Bretonbanquet, Risssa, Joelmills, Shlomke, Goodnightmush, Slakr, KirrVlad, DeLtA,
Tawkerbot2, Ataricom, Ale jrb, Sir Vicious, JohnCD, Cydebot, Asymptote, Anthonyhcole, Kansas Sam, Crockspot, Luminifer, Headbomb, Shinji nishizono, Rlitwin, Prolog, Spencer, Harry0005, Gkhan, JAnDbot, Lediur, MER-C, Scott0485, Hut 8.5, Vl'hurg, Magioladitis, Bongwarrior, JBKramer, Deolankar, Karl432, WhatamIdoing, Antorjal, Hintswen, Yobol, MartinBot, Parlemer, Nono64, PrestonH,
Manticore, J.delanoy, CFCF, Bogey97, Dispenser, Trumpet marietta 45750, Mikael Hggstrm, 2wingo, Phirazo, Que-Can, Lepurix,
Moonksy29, DorganBot, Idioma-bot, CWii, VasilievVV, Bsroiaadn, Philip Trueman, Drestros power, Una Smith, Timpul, Cool moe dee
345, Dawaegel, Psyche825, Madhero88, Sardaka, Ecgecg, Doc James, Bfpage, SieBot, Raella, Sonicology, Caltas, Meightysix, Flyer22 Reborn, Wolf858, Mimihitam, Arnobarnard, Johndheathcote, Billyg, Nikuda, ClueBot, The Thing That Should Not Be, Avaeaston, Blogeswar,
NuclearWarfare, Bald Zebra, Aitias, XLinkBot, Allsaints23, Addbot, Intellect123, PaleWhaleGail, Nohomers48, Mentisock, Ccacsmss,
Pwnedurmawm, LinkFA-Bot, Numbo3-bot, Lightbot, OlEnglish, Luckas-bot, Yobot, KamikazeBot, AnomieBOT, Champio30, Sonia,
Clarinetguy097, Citation bot, ArthurBot, Capricorn42, Drchazz, Den e 2011, Omnipaedista, 12, Ajax151, Hersfold tool account,
FrescoBot, Atlantia, Citation bot 1, Pinethicket, VenomousConcept, Mal from cessnock, TobeBot, Trappist the monk, Diblidabliduu,
Kalaiarasy, Paiamshadi, Cwbvb13, Alo180, Justito, Reach Out to the Truth, Angelito7, TjBot, EmausBot, WikitanvirBot, Minimacs
Clone, Wham Bam Rock II, Thecheesykid, ZroBot, Modernboy8, Mikeef, Netha Hussain, Teto4fun, Hudson Stern, Usb10, Hazard-Bot,
Michael Bailes, ClueBot NG, KlingonDoctor, Wimpus~enwiki, O.Koslowski, CopperSquare, Widr, Paladin5555, Jk2q3jrklse, HMSSolent, BG19bot, Nen, MusikAnimal, Mark Arsten, Onewhohelps, Muendelezaji, Vitusberingbg, Thanksvoltaire, BattyBot, Lowrizzle, Several Pending, Cimorcus, 65sharad, TylerDurden8823, Bs11htab, JYBot, Dexbot, Bilingual2000, Lugia2453, Ozzie10aaaa, Epicgenius,
MatthewJ00, Melonkelon, Pwoolfy, Froglich, Ginsuloft, Jackmcbarn, JaconaFrere, Iudicium, ShreiksofaNav, Foroey, Monkbot, Johnhaygarth, Ddvds, Chanceober, Killthrill66745, BLEONOGN, KasparBot, Barbara (WVS) and Anonymous: 313

11.2

Images

File:Rabies_Virus_EM_PHIL_1876.JPG Source: https://upload.wikimedia.org/wikipedia/commons/5/57/Rabies_Virus_EM_PHIL_

1876.JPG License: Public domain Contributors: http://phil.cdc.gov/PHIL_Images/03082002/00012/PHIL_1876_lores.jpg high res.: Original artist: ?
File:Spinal_tap_newborn.JPG Source: https://upload.wikimedia.org/wikipedia/commons/d/d2/Spinal_tap_newborn.JPG License:
GFDL Contributors: Own work Original artist: Bobjgalindo

11.3

Content license

Creative Commons Attribution-Share Alike 3.0