ENCEPHALITIS PATHOPHYSIOLOGY

ARTHROPOD-BORNE VIRUS ENCEPHALITIS

• Is an acute inflammation (swelling) of
the brain usually resulting from either a MODE OF TRANSMISSION
viral infection or due to the body’s own
-Mosquito bites an infected bird.
immune system mistakenly attacking
brain tissues. -Mosquito becomes infected.

-It carries the virus to humans by biting.

TYPES OF ENCEPHALITIS INCUBATION PERIOD
Herpes Simplex Encephalitis -With a range from 4-21 days
 Is an acute inflammatory process of the Virus
brain tissue.
-Replicates at the site of the mosquito bite
Arthropod-Borne Virus Encephalitis
(Arboviruses) -Gains access to CNS either by hematogenous
spread or by travelling along neural and
 Maintained in nature through biologic olfactory pathways.
transmission by blood feeding
-Spreads from neurons to neurons affecting the
arthropods. For example, mosquitoes,
corticol gray matter, the brainstem and the
ticks.)
thalamus
Fungal Encephalitis
-and nagkakaron ng GENERAL MANIFESTATIONS
 Rarely in people who are healthy. Or sa na sa ating katawan.
mga taong compromised na yung
immune system due to disease or
immunosuppressive medications. PATHOPHYSIOLOGY
FUNGAL ENCEPHALITIS

The fungal spores enter the body via inhalation.

PATHOPHYSIOLOGY
They infect the lungs causing respiratory
HERPES SIMPLEX ENCEPHALITIS
symptoms or pneumonitis. The fungi may enter
 The pathology of encephalitis involves the bloodstream causing fungemia. And if yung
local necrotizing hemorrhage that fungemia is na engulf na yung immune system
becomes more generalized followed by pwede syang magspread sa Central Nervous
edema. And there is also a progressive System which can cause meningitis,
deterioration of nerve cell bodies. encephalitis, brain abcess, granuloma or
arterial thrombus.
CLINICAL MANIFESTATIONS LABS/DIAGNOSTICS TEST

• Herpes Simplex Encephalitis CEREBRAL SPINAL FLUID COLLECTION: CSF

COLLECTION helps to differentiate the condition
o Fever, headache, confusion and
from meningitis
hallucinations, behavioral
changes, focal seizures, Electroencephalogram: EEG
dysphasia, hemiparesis and (electroencephalograph) that monitors the
altered Level Of Consciousness. electrical activity of the brain may show sharp
waves in one or both of the temporal lobes in
• Arthropod-Borne Virus Encephalitis
patients with encephalitis.
o Flulike symptoms, SIADH with
MRI: the best imaging option for encephalitis; it
hyponatremia, stiff neck, can identify the classic brain changes that
confusion, dizziness and suggest encephalitis.
tremors.
CT SCAN: may be useful in detecting changes in
• Fungal Encephalitis brain structure. It can also rule out other
o Fever, malaise, headache, causes, such as stroke, an aneurysm, or a tumor
meningeal signs, change in PCR TEST (polymerase chain reaction): Test
Level Of Consciousness or that detects tiny amounts of virus in DNA The
cranial nerve dysfunction, test detects the presence of a virus if you are
increased Intra Cranial infected at the time of the test. The test could
Pressure. also detect fragments of virus even after you
are no longer infected.

RISK FACTORS Blood and urine tests: Blood and urine tests
that may be helpful include the following:
AGE: more common or more severe sila in  Complete blood count (CBC)
certain age groups. Young children and older  Serum electrolyte levels
adults ang greater risk of most types of viral  Serum glucose level
encephalitis.  Blood urea nitrogen (BUN) and
creatinine levels
WEAKENED IMMUNE SYSTEM: Yung may mga  Urine electrolyte levels
HIV/AIDS, nagte-take ng immune-suppressing  Urine or serum toxicology
drugs or may ibang condition na pwedeng mag screening
cause para humina ang immune system nila ay  Tests that detect antibodies to a virus
mataas din ang risk for encephalitis. (serology tests)
GEOGRAPHICAL REGIONS: Mosquito- or tick-
borne viruses are common in particular
geographical regions.

SEASON OF THE YEAR: Mosquito- and tick-

borne diseases tend to be more common in
summer and rainy season.
 Risk for Trauma/Suffocation: risk factors may
MEDICAL MANAGEMNET include restlessness, altered LOC, cognitive
impairment; generalized weakness
Antiviral medications, such as acyclovir
(Zovirax) and foscarnet (Foscavir) - to treat • Explain to client the various stimuli that
herpes encephalitis or other severe viral may precipitate seizure activity.
infections (however, no specific antiviral drugs
Alcohol, various drugs, and other stimuli, such
are available to fight encephalitis)
as loss of sleep, flashing lights, and prolonged
Antibiotics - if the infection is caused by certain television viewing, may increase the potential
bacteria for seizure activity. Client may or may not have
control over many precipitating factors, but
Anti-seizure medications (such as phenytoin) -
may benefit from becoming aware of risks.
to prevent seizures.
• Discuss seizure warning signs, if
Steroids (such as dexamethasone) - to reduce
appropriate, and usual seizure pattern.
brain swelling (in rare cases)
Teach significant other to recognize
Sedatives - to treat irritability or restlessness warning signs and how to care for client
during and after seizure.
Acetaminophen - for fever and headache
Can enable client or SO to protect individual
from injury and to recognize changes that
NURSING DIAGNOSIS: require notification of physician and further
intervention. Knowing what to do when seizure
Acute Pain may be related to inflammation or occurs can prevent injury or complications and
irritation of the brain and cerebral edema decreases SO’s feelings of helplessness.
• Give analgesics as ordered. • Keep padded side rails up with bed in
• Eliminate additional stressors or lowest position, or place bed up against
sources of discomfort whenever wall, and add floor pad if rails are not
possible. (example: dimming the lights, available.
limiting noise and visitors) Minimizes injury should frequent or generalized
• Provide rest periods to facilitate seizures occur while client is in bed.
comfort, sleep, and relaxation. • Maintain strict bedrest if prodromal
• Teach Relaxation Exercises or signs or aura is experienced. Explain
Techniques. (breathing exercises, music necessity for these actions.
therapy) Ang goal po ng techniques Client may feel restless, need to ambulate or
nato is to reduce tension and to even defecate during aural phase, thereby
subsequently reduce pain. inadvertently removing self from safe
environment and easy observation.
Understanding importance of providing for own
safety needs may enhance client cooperation.
 • Stay with client during and after seizure.

Promotes client safety and reduces sense of

isolation during event.

• Turn head to side during seizures

Helps maintain airway

• Cradle head, place on soft area, or assist

to floor if out of bed. Do not attempt to
restrain.

Gentle guiding of extremities reduces risk of

physical injury when client lacks voluntary
muscle control. Note: If attempt is made to
restrain client during seizure, erratic
movements may increase, and client may injure
self or others.

• Perform neurological and vital sign

checks after seizure: level of
consciousness, orientation, ability to
comply with simple commands, ability
to speak, memory of incident, weakness
or motor deficits, blood pressure (BP),
pulse, and respiratory rate.

Documents postictal state and time and

completeness of recovery to normal state. May
identify additional safety concerns to be
addressed.

• Reorient client following seizure activity

Client may be confused, disoriented, and

possibly amnesic after the seizure and need
help to regain control and alleviate anxiety.