INFECTION OF THE BRAIN -ENCEPHALITIS ( PPT)

Neurological system includes brain and spinal cord. It plays an important role in functioning of our body. Encephalitis is the inflammation of the brain. Causes include viral infections, infections from insect bites or an autoimmune reaction that affects the brain. It can be life-threatening or cause long-term complications. Treatment varies, but most people require hospitalization so they can receive intensive treatment, including life support.

1. DISEASES OF NERVOUS SYSTEM Mrs. BLESSY THOMAS VICE PRINCIPAL FNCON,SHAHJAHANPUR

2. DEFINITION Encephalitis is an acute inflammation of the brain. Encephalitis is inflammation of the active tissues of the brain caused by an infection or an autoimmune response. The inflammation causes the brain to swell, which can lead to headache, stiff neck, sensitivity to light, mental confusion and seizures.

3. CAUSES viral infections - Viruses cause about 70% of encephalitis cases, with young children (ages 1 year and under) and older adults (ages 65 years and over) being the most susceptible age demographics. Herpes simplex virus (HSV) Other herpes viruses -- Includes Epstein-Barr virus, and the varicella-zoster virus. Enteroviruses--poliovirus and the coxsackievirus,  Mosquito-borne viruses. Tick-borne viruses Rabies virus. Childhood infections.

4. Causes it can be caused by bacteria or even fungi. In children, elderly, and those with a weak immune system are most vulnerable. The exact cause of encephalitis is often unknown. Autoimmune inflammation. Non-infectious inflammatory conditions.

5. RISK FACTORS Age.  more common or more severe in certain age groups. In general, young children and older adults are at greater risk of most types of viral encephalitis. Weakened immune system.   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.

6. TYPES Primary encephalitis- occurs when a virus directly infects the brain and spinal cord. The infection may be concentrated in one area or widespread. A primary infection may be a reactivation of a virus that had been inactive after a previous illness.

7. TYPES Secondary encephalitis - occurs when an infection starts elsewhere in the body and then travels to your brain  Instead of attacking only the cells causing the infection, the immune system mistakenly attacks healthy cells in the brain. Also known as post-infection encephalitis, secondary encephalitis often occurs 2 to 3 weeks after the initial infection.

8. TYPES Viral encephalitis Caused by viral infections. Resolves without specific treatment within two weeks . It is also called as aseptic meningitis.

9. TYPES Bacterial encephalitis Quite severe and may result in brain damage, hearing loss learning disability and death

10. TYPES Fungal encephalitis It is much less common than the other two infections. It is rare in healthy people. Common in people with altered immune system.

11. TYPES Post ischemic inflammatory encephalitis Occurs after stock as a complication.

12. PATHOPHYSIOLOGY Due to etiological factors. Crosses the BBB or direct entry. Microbial growth and multiplication in the cerebral tissue. Inflammation in brain parenchyma and neuronal cells. Local necrotizing hemorrhage that becomes more generalized. Edema and increased ICP Progressive deterioration of nerve tissue.

13. CLINICAL MANIFESTATIONS Physical Symptoms Fever Seizures Headache Movement disorders Sensitivity to light Sensitivity to sound Neck stiffness Loss of consciousness In severe cases, encephalitis symptoms may include: Weakness or partial paralysis in the arms and legs Double vision Impairment of speech or hearing Coma

14. CLINICAL MANIFESTATIONS Cognitive Symptoms Excessive sleepiness Confusion and disorientation Irritability Anxiety Psychosis Hallucinations Memory loss Other behavioral changes Cognitive impairment

15. CLINICAL MANIFESTATIONS Problems in walking Bowel and blad der problems Headache Nausea and vomiting Fever Aches in muscles or joints Fatigue or weakness

16. CLINICAL MANIFESTATIONS In infants and young children, signs and symptoms might also include: Bulging in the soft spots (fontanels) of an infant's skull Nausea and vomiting Body stiffness Poor feeding or not waking for a feeding Irritability

17. DIAGNOSTIC EVALUATION History collection . physical examination. Brain imaging with CT scan or MRI CT scans and MRI detect changes in brain structure. They can rule out other possible explanations for symptoms, such as a tumour or stroke.

18. DIAGNOSTIC EVALUATION Electroencephalograph (EEG) An EEG uses electrodes (small metal discs with wires) attached to the scalp to record brain activity. An EEG does not detect the virus that causes encephalitis, but certain patterns on the EEG may alert . Blood tests A blood test can reveal signs of a viral infection.

19. DIAGNOSTIC EVALUATION Spinal tap or lumbar puncture In this procedure- will insert a needle into lower back to collect a sample of spinal fluid. They will test the sample for signs of infection. Brain biopsy In a brain biopsy, -will remove small samples of brain tissue to test for infection. This procedure is rarely performed because there’s a high risk of complications.

20. MANAGEMENT MEDICAL MANAGEMENT PHARMACOLOGICAL MANAGEMENT Anti-inflammatory drugs antipyretics- Acetaminophen, Ibuprofen, Naproxen sodium. Antiviral drugs- Acyclovir, Ganciclovir. Mannitol or Glycerol may be needed to reduce ICP. Corticosteroids Antibiotics Vitamin and mineral supplementation IV fluids therapy and dopamine to be given to treat shock fluid electrolyte imbalance. Anticonvulsive drugs.

21. MEDICAL MANAGEMENT Immunotherapy, such as steroids, intravenous antibodies (IVIg) or plasma exchange, to address certain types of autoimmune encephalitis. A breathing tube, urinary catheter, or feeding tube may be necessary if the person’s encephalitis has caused loss of consciousness. Plasma exchange If it is autoimmune immunotherapy

22. MEDICAL MANAGEMENT NON –PHARMACOLOGICAL MANAGEMENT Oxygenation to be provided by nasal cannula. Mechanical ventilation is necessary in cardio-respiratory insufficiency.

23. Complications Coma or death. Persistent fatigue Weakness or lack of muscle coordination Personality changes Memory problems Paralysis Hearing or vision defects Speech impairments

24. PREVENTION Practice good hygiene.  Wash hands frequently and thoroughly with soap and water, particularly after using the toilet and before and after meals. Don't share utensils.  Don't share tableware and beverages. Teach children good habits.   Protection against mosquitoes and ticks Apply mosquito repellent.   Use insecticide.  . Get vaccinations.

25. FOLLOW-UP THERAPY Brain rehabilitation  to improve cognition and memory. Physical therapy  to improve strength, flexibility, balance, motor coordination and mobility. Occupational therapy  to develop everyday skills and to use adaptive products that help with everyday activities. Speech therapy  to relearn muscle control and coordination to produce speech. Psychotherapy  to learn coping strategies and new behavioral skills to improve mood disorders or address personality changes.