Encephalitis is a group of inflammatory diseases of the substance.
brain that are infectious, allergic or
toxic nature. If a patient is diagnosed with a disease,
he should be hospitalized immediately. With human encephalitis
placed in infectious or specialized neurological
separation and appoint the strictest bed rest and permanent
What is encephalitis?
Энцефалит (лат. encephalitis — воспаление мозга) — это
the name of the whole group of inflammatory processes affecting the head
human brain appearing on the background of exposure to infectious
pathogens and allergic agents, toxic substances.
Changes in the nervous tissue in encephalitis are quite stereotypical, and
only in some cases can the signs of a specific
diseases (rabies, for example). Value for the body and
the effects of any inflammatory brain changes always
serious, so do not once again remind them
In the acute stage in the substance of the brain, it causes
inflammatory process, affecting the hypothalamus, basal nuclei, nuclei
oculomotor nerves. In chronic стадии развивается токсико
– the degenerative process is most pronounced in the substantia nigra and
The incubation period for encephalitis varies from one to two
In case of encephalitis of any etiology, complex
therapy. It usually involves etiotropic treatment.
(antiviral, antibacterial, antiallergic),
dehydration, infusion therapy, anti-inflammatory treatment,
vascular and neuroprotective therapy, symptomatic
Classification энцефалитов отражает этиологические факторы,
related clinical manifestations and features of the course.
The timing of occurrence are distinguished:
- primary encephalitis (viral, microbial and rickettsial)
- secondary (posteksantemnye, post-vaccination, bacterial and
parasitic, demyelinating). The second type occurs on the background
various diseases (influenza, toxoplasmosis, measles, osteomyelitis and
Depending on the presence of inflammation of the meningeal membranes
(brain membranes) distinguish the following forms of encephalitis:
- isolated – the clinic has symptoms only
- meningoencephalitis – symptoms are also present in the clinic
воспаления оболочек the brain.
- damage to the cerebellum.
According to the pace of development and flow:
- moderately severe;
- extremely heavy.
The most common cause of encephalitis are viruses.
neuroinfection sometimes also occurs as complications
various infectious diseases.
The causative agent of primary encephalitis is a virus transmitted by
through the bite of blood-sucking parasites (Coxsackie-virus, herpes, flu,
rabies, arboviruses). There are also microbial
encephalitis: syphilitic and typhoid variants.
A common cause of progression is
neuroinfection. It is worth noting that the etiology of the disease directly
depends on its type. So, the causes of viral progression
encephalitis are: the bite of infected insects (usually
carriers are mosquitoes or ticks), penetration into the body
flu virus, herpes, rabies.
Ways of penetration of the virus into the human body:
- insect bite (hematogenous route);
- by direct contact;
- alimentary way;
- airborne path.
The disease can develop in any person, but older people and
children are most at risk. Disease also prone
those whose immune system is depressed or weakened by any
exposure to, for example, cancer treatment, HIV infection or
long-term use of steroids.
Symptoms of encephalitis
Болезнь обычно начинается с лихорадки и головной боли,
then the symptoms increase sharply and worsen – convulsions are observed
(seizures), confusion and loss of consciousness, drowsiness and even coma.
Encephalitis can pose a serious threat to life.
Symptoms of encephalitis depend on many factors: pathogen
diseases, its pathology, course and localization.
The disease in many situations manifests itself as aching, and
also pain. However, these unpleasant symptoms affect the whole body:
However, there are common to all types of encephalitis.
- headache – it is most often expressed in all areas of the head
(diffuse), can be pressing, arching;
- nausea and vomiting, not bringing relief;
- torticollis, tremor, convulsive seizures;
- the main symptom of encephalitis is a sharp rise in temperature
to high values (39–40 ° С);
- eye movement disorders: ptosis (omission of the upper eyelid),
diplopia (doubling), ophthalmoplegia (lack of eye movements
- It is rarely possible to damage the facial nerve with the development of paresis.
facial muscles, trigeminal nerve with pain in the face, are possible
Depending on the type of pathogen, the time interval between
infection and manifestation of the first symptoms lasts from 7 to 20 days.
In the latent period, the infection does not show itself;
the presence of the pathogen is possible only in the laboratory.
Other possible signs of encephalitis:
- increased muscle tone;
- involuntary movements (hyperkinesis);
- squint, violation of eyeball movements
- diplopia (double vision);
- ptosis (omission) of the upper eyelid;
Another characteristic feature is muscle twitching in humans.
These twitches are done involuntarily. It is important to note
that sometimes a person is worried about numbness of the skin, which is manifested in
different parts of the body.
Types of encephalitis
Despite all the variety of causes and types, its manifestations
quite stereotypical in severe illness, but if
inflammation of the nervous tissue accompanies other ailments, then recognize
Encephalitis as such is not so simple.
Epidemic Encephalitis Economo (lethargic encephalitis
The causative agent is a filterable virus that
today is not highlighted. This type of virus is transmitted.
by airborne droplets.
Signs of evolving epidemic encephalitis:
- temperature increase up to 38-39 degrees;
- increased sleepiness;
- lack of appetite;
In this case, urgent hospitalization is required. Exactly
the duration of the incubation period is unknown, therefore all
contact with a sick person must within three months
Tick-borne encephalitis входит в группу природно-очаговых заболеваний
person The custodians and carriers of the virus are ixodic
ticks. In addition, the virus can be stored rodents – hedgehog, hare, field
mouse, chipmunk; birds – goldfinch, blackbird, chaffinch, and also predatory
animals are wolves.
The disease develops acutely, 1.5-3 weeks after the bite.
The virus infects the gray matter of the brain, motor neurons
spinal cord and peripheral nerves, which manifests itself convulsions,
paralysis of individual muscle groups or whole limbs and impaired
The disease often begins acutely, with chills and fever.
bodies up to 38–40 ° С. Fever lasts from 2 to 10 days. Appear general
malaise, severe headache, nausea and vomiting, fatigue,
fatigue, sleep disturbance. In the acute period, marked hyperemia
skin of the face, neck and chest, mucous membrane of the oropharynx, injection
sclera and conjunctiva.
Complications of tick-borne encephalitis are mainly represented by flaccid
paralysis mainly of the upper limbs.
Influenza (toxic hemorrhagic) encephalitis
Progresses against the background of the flu. It is diagnosed in adults and
children. Symptoms occur:
- severe headache, nausea, dizziness,
- muscle pain
- weight loss
- sleep disorders.
This inflammatory brain disease can lead to
epileptic seizures, paralysis or coma.
Measles encephalitis (encephalomyelitis)
This complication of measles most often develops 3-5 days after
rash appears, by this time the body temperature can already
normalize, but when encephalitis occurs, a new
temperature jump to high numbers.
The onset of the disease is acute with a repeated rise in body temperature,
disturbances of consciousness from stupor to coma, the development of convulsive
syndrome in the form of local or generalized tonic-clonic
seizures. Psychosensory disturbances, delusions, hallucinations are possible.
The frequency of lesions of the nervous system in children with measles is
0.4 – 0.5%, in adolescents and adults – 1.1 – 1.8%. Koreva
тип развивается с частотой 1:1000 больных корью.
Herpetic энцефалит вызывает вирус простого герпеса.
Поражаются кора и белое вещество большого the brain. Arises
necrotic process (focal or widespread).
Polison энцефалиты, как правило, вызываются вирусами
Коксаки и ЕСНО. The disease can develop at any time.
years, manifested by headache, moderate fever, may
develop paresis for a short time (the motor
function of individual muscles).
Toxoplasmosis энцефалит служит основной причиной
morbidity and mortality in patients with AIDS. Gated infection
digestive organs are more common, although there are cases
intralaboratory infections with highly virulent Toxoplasma strains
if skin is damaged (with a pipette or syringe with a Toxoplasma culture).
К частым признакам относят: озноб, лихорадку, головную боль,
seizures, depression and neurological disorders.
Japanese (encephalitis B)
This type of encephalitis is especially common in Asian countries.
The reservoir and source of infection are wild and domestic.
animals, birds, rodents. Animals suffer infection in hidden
form with the rapid elimination of the pathogen from the blood. Sick person
with carriers, it can also be a source of infection.
In general, Japanese encephalitis is diagnosed very rarely, epidemics
It never happened. For the onset of the disease is characterized by increased
body temperature, headaches and chills.
Complications and consequences for humans
The consequences of the transferred encephalitis is very heavy –
the inflammatory process concerns the central nervous system that
can lead to disability of the patient.
The main complications of encephalitis:
- swelling of the brain;
- brain coma;
- development of epilepsy;
- life-long carrier of the virus;
- impaired vision, speech, hearing;
- memory impairment;
- flaccid paralyzes;
- mental disorders;
- risk of death.
Encephalitis is fraught with danger in relation to the full life
sick, it can cause not only disability, but also
For the diagnosis of encephalitis is a spinal puncture.
To clarify the diagnosis and differential diagnosis investigate
the fundus, electroencephalography, echoencephalography,
tomography, etc. When establishing the diagnosis, the patient should be
hospitalized in the infectious or neurological department.
- general and biochemical blood tests, urine tests,
- blood culture for sterility,
- puncture with obtaining cerebrospinal fluid,
- performing a REG or EEG, fundus examination,
- CT or MRI,
- if necessary, a biopsy is performed.
Diagnosis and treatment of disease in children and adults engaged in
infectious disease physician. If the diagnosis was confirmed, then the patient
immediately placed in the hospital, in the infectious disease ward.
Shows strict bed rest. The patient’s condition is constantly
When treating encephalitis specialists may encounter
с необходимостью восстановления правильного метаболизма внутри
the brain. To do this, prescribe the use of special vitamins,
piracetam or polypeptides. Among anti-inflammatory drugs
часто назначают салицилаты и ибупрофен.
- Antipyretic drugs
- Anti-inflammatory (glucocorticoids)
- Anticonvulsant therapy (benzonal, difenin, finlepsin)
- Detoxification therapy (salt solutions, protein
drugs, plasma substitutes)
- Resuscitation (ventilator, cardiotropic drugs)
- Prevention of secondary bacterial complications (antibiotics
To restore normal functioning of the nervous system
и реабилитации сознания назначают всевозможные биостимуляторы,
antidepressants or tranquilizers.
If the disease leads to impaired respiratory function, then
conduct artificial respiration. Also assigned
anticonvulsants and analgesics.
Vaccines are the most effective way to reduce risk.
development of the disease. In this case, it is not only about vaccinations against
tick-borne encephalitis, but also on the prevention of pathologies such as
measles, parotitis, rubella, etc.
Therefore, do not neglect vaccination (vaccination) against
certain types of encephalitis when traveling to areas with
unfavorable in relation to the disease situation.
All encephalitis is treated in infectious diseases hospitals. In chronic
stage requires regular visits to the neurologist, and
courses to take medications aimed at improving activity
brain, the restoration of atactic and motor defects.
Preventive measures to prevent various
types of encephalitis are different and are represented by the following
- Preventive measures capable whenever possible
prevent tick-borne and mosquito-encephalitis infections, are
preventive vaccination of people living and / or working in
possible infection zones. Standard vaccination against tick-borne
encephalitis includes 3 vaccinations and gives lasting immunity for 3
of the year.
- Prevention вторичных энцефалитов подразумевает своевременную
diagnosis and adequate treatment of infectious diseases.
- Restriction of tourist trips to countries where it is possible
viral encephalitis infection through mosquito bites.