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ENCEPHALITIS Carol Kirrane Lecturer Practitioner CONTENTS • • • • • • A&P Facts about encephalitis Signs & Symptoms Contagiousness Diagnosis Treatment What is Encephalitis?? • Literally means an inflammation of the brain • Usually refers to brain inflammation caused by a virus • May also be called acute viral encephalitis or aseptic encephalitis Types of Viruses that Cause Encephalitis • The most dangerous is the Herpes Simplex virus (HSV)- the same virus that causes cold sores but when it attacks the brain it may be fatal in half those that are infected • HSV is very rare • Some forms are transmitted by insects e.g. West Nile virus from mosquitoes that pick virus up from infected birds • Milder forms of encephalitis can follow common childhood illnesses • Measles, mumps, chicken pox, Rubella (German measles) • One in every 1000 people with measles will develop measles encephalitis- develops 4 to 7 days after rash appears • Less commonly encephalitis can result from a bacterial infection, such as meningitis • May be a complication of other infectious diseases such as rabies, syphilis or HIV • Many cases may go unreported because symptoms so mild Signs & Symptoms • • • • • • • Fever with hallucinations Headache – may be severe with double vision Nausea & Vomiting Raised ICP- Stiff neck, pupils, motor weakness Confusion, personality changes, convulsions Poor appetite Loss of energy Infants • Harder to detect symptoms • Important signs- vomiting, a full or bulging soft spot (fontanel) • Crying that does not stop and worsens when the patient is picked up • Body stiffness Contagiousness • Brain inflammation itself is not contagious • Any of the viruses that cause encephalitis can be- to be safe children should avoid contact with anyone who has encephalitis • Mosquitoes spread through bites • Herpes or chicken pox spread mostly via fluids of the nose & throat (cough/sneeze) Diagnosis • Signs & Symptoms • Imaging such as CT/MRI to check for brain swelling • EEG – abnormal brain waves • Blood test- Confirm presence of bacteria/viruses in blood and antibodies to fight infection • LP Analysis of CSF Treatment • Children with mild encephalitis can be monitored at home- usually will be nursed in ITU • Monitor neuro obs, vital signs & body fluids to prevent further swelling • Antiviral drugs for some forms e.g. HSV • Reduce ICP- position, steroids Duration • Acute phase of illness when symptoms most severs lasts up to a week • Full recovery can take much longer often several weeks • May have permanent damage or need intensive rehabilitation – Centre of Enablement Complications • Most people make a full recovery • Small percentage 5% can lead to permanent brain damage or learning disabilities such as speech problems, memory loss or lack of muscle control • May need OT & Physio • Rarely leads to death • Infants younger than 1 year and adults over 55 are at greatest risk of death • Herpes encephalitis is usually fatal if no anti viral drugs used Prevention • Cannot be prevented except to try to prevent the disease that may lead to it • Have your child immunised • Children avoid contact with people with encephalitis • Protection from mosquitoes/ticks- limit soil contact, check pets for ticks The Encephalitis Society • Based in Malton North Yorkshire open Mon- Fri 9-5pm • Tel 01653 699 599 • Email: [email protected] • Give info & direct support for Pts and carers Key Nursing Issues • Risk of ICP- Neuro obs report deterioration (check resps!!) • Safety- Assess mobility –risk of falls, cognition, confusion (use of wanderguard), disorientation • Where to place on ward – near nurses station v side room if shouting/noisy • QUESTIONS???????????????