Encephalitis Lecture Notes

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Encephalitis

– Acute inflammatory disease of the brain

– Usually viralà over 25 types

– Herpes Simplex: most common sporadic type

– Cytomegalovirus: usually assoc. with HIV

– Acute febrile illness with symptoms of meningitis AND neurologic signs such as aphasia,  seizures, cranial nerve involvement

– Patient may present with fever, facial paralysis, headache, seizures, nausea and  vomiting

– CT scan usually initially normal; MRI more helpful

– Need brain biopsy for pharmaceutical treatment

–  Herpes simplexà Zovirax

– Death occurs in 70-80% of patients if treatment not begun before patient  becomes comatoseà 28% if treatment begun early

Seizure Disorders

A seizure is an abnormal, unregulated electrical discharge that occurs within the brain’s cortical gray  matter and transiently interrupts normal brain function. A seizure typically produces altered awareness,  abnormal sensations, involuntary movements, or convulsions. . It may affect a small focal area of the  brain, or the entire brain (generalized). The area affected by the seizure loses its regular ability of function  and may react uncontrollably. For example, if an area of the brain that controls an arm has a seizure, the  arm may shake repetitively. If a seizure affects the entire brain, all the extremities may shake  uncontrollably. Theoretically, any function of the brain, motor, smell, vision, or emotion may be  individually affected by a seizure.

An isolated seizure can be provoked in a normal brain by reversible stressors (eg, hypoxia, hypoglycemia;  in children, fever). A seizure disorder (epilepsy) is diagnosed when a patient has ≥ 2 seizures not related  to reversible stressors.

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