And whether you know...
Encephalitis is the inflammatory process happening in a brain.
It is accepted to distinguish encephalitis primary and secondary. In turn, primary type of an illness includes a number of types of encephalitis: tick-borne, epidemic, enteroviral, mosquito, herpetic, etc. Encephalitis secondary is shown against other diseases: measles, flu, abscess of a brain, toxoplasmosis, etc.
There is a classification of a disease according to its etiology and a pathogeny: it is accepted to distinguish encephalitis infectious, allergic, infectious and allergic, toxic. At polyencephalitis gray matter of a brain is surprised, at a leykoeitsefalita – white matter. If the person has a defeat of white and gray matter, then in this case the panencephalitis takes place.
Distinguish also diffusion and limited encephalitis, and according to a current divide an illness into acute, subacute and chronic encephalitis.
This disease arises owing to influence of the filtered virus. Infection happens by a contact or airborne method. In this case the incubation interval can proceed from days to two weeks. The virus gets into an organism and affects a brain. In substance and covers of a brain there is a development of an inflammation, the hyperemia is shown. At an acute stage of a course of a disease at the person body temperature suddenly increases up to 38 °C. If the centers of thermal control are surprised, then temperature can be higher. As the main symptom of epidemic encephalitis at the person the expressed sleep disorder is observed: the person constantly stays in a condition of drowsiness or suffers from sleeplessness. Also drowsiness and lack of a dream can be observed in the afternoon at night. As other symptoms of encephalitis it should be noted emergence of oculomotor frustration, inflammatory reaction of blood of nonspecific character. The acute phase of an illness proceeds about two-three weeks, after that approximately in half of cases of people recovers completely or partially. In 50% of cases the disease takes chronic shape. In this case encephalitis symptoms descents with symptoms of trembling paralysis. Also at the person changes of mentality can be shown. At a chronic form of a disease encephalitis can progress owing to what there comes disability.
For treatment of epidemic encephalitis often appoint the medicines with antiviral action dehydrating and desensibilizing means, vitamins.
This disease has exclusively seasonal nature, arises in the spring and in the flying. The main source of infection are the ixodic ticks living in the woody district. A tick-borne encephalitis is shown after penetration into a virus organism owing to a sting of the infected tick. In more exceptional cases infection occurs in the alimentary way, for example, after the use of milk from the infected animals. The incubation interval of a disease can last from 8 to 20 days; if the sting was come to mind, then the incubation interval is shortened and lasts from 4 to 7 days. The illness begins with an acute current: the person suffers from vomiting, a severe headache, a photophobia. Sharply body temperature increases, reaching 39-40 °C. Sometimes at a tick-borne encephalitis there is a repeated hyperthermia. In this case symptoms of encephalitis are even more expressed. At the patient the hyperemia of scleras, a pharynx, skin, various dispepsichesky frustration is shown. At blood test increase SOE, a leukocytosis, a lymphopenia is observed. In especially serious cases respiratory muscles can be surprised, be shown bulbar frustration.
Tick-borne encephalitis has several clinical forms: poliomiyelitichesky, meningeal, polioencephalomyelitic, cerebral and erased.
At a meningeal form of a tick-borne encephalitis pronounced meningeal symptoms are shown. The person in view of an inflammation of a brain and its covers has frustration of consciousness, epileptic seizures, nonsense, paralysis. Displays of spasms with probability of their transition to the general convulsive attack are possible.
At encephalitis of a polioencephalomyelitic form at the patient sluggish paralysis of muscles of a shoulder girdle, a neck is shown. Manifestation of bulbar and shell frustration is possible.
At patients with a polnomiyelitichesky form of encephalitis as symptoms paresis and paralyzes of a neck, hands are shown, at the patient on a breast the head unnaturally hangs down. Sensitivity at the person is not broken, however failure of motive functions is shown. At the erased form of a tick-borne encephalitis for two-four days at the patient fever is observed, neurologic symptoms are not shown, however there is tachycardia, periodic attacks of arterial hypertension. Also the progreduated form of an illness at which periodic twitchings of certain groups of muscles are noted is allocated. Generally it is muscles of hands and a neck.
The Japanese encephalitis (other name — encephalitis In) provokes a virus which is kept and transfer mosquitoes. Birds, people can sometimes be carriers of viruses. In this case the incubation interval proceeds from three to twenty seven days. The disease begins to be shown sharply: body temperature sharply rises to 40 °C and above, without falling for about 10 days. The patient is annoyed by a febricula, a fever, weakness severe headaches, vomiting, muscular pains. The face skin hyperthermia, dryness of language is observed, the stomach is strongly pulled in. Also disturbances in cordial activity and in consciousness of the patient are possible. Increase of a tone of sgibatel of upper extremities and at the same time razgibately the lower extremities is noted. Twitchings of some muscles, periodic spasms are sometimes shown. At heavy disease bulbar paralyzes can be shown. At this disease the death occurs approximately in 50% of cases.
Other forms of encephalitis
Against flu influenzal encephalitis is shown (other name — toksiko-hemorrhagic encephalitis). At an inflammation of a brain of this type neurologic symptoms against symptoms of flu are shown. The main symptoms of encephalitis are severe headaches, nausea, dizzinesses. Moving eyeglobes, the person feels pain. Manifestations of a dorsodynia, muscles of hands, legs, and also in trifacial exit points are possible. Influenzal encephalitis can provoke anorexia, problems with a dream.
Display of paresis, paralyzes, coma is characteristic of an encephalomeningitis, and also epileptic seizures in some cases can be observed. At clumsy encephalitis which can develop approximately for 3-5 day after at the patient rash is shown there is a defeat in the basic of white matter, both a head, and spinal cord. At development of this form of encephalitis the condition of patients repeatedly worsens, body temperature increases. Encephalitis symptoms in this case can be different. So, one patients complain of the general manifestation of weakness, drowsiness which can pass into a coma. Other patients endure nonsense and disturbance of consciousness, epileptic seizures, they can stay periodically in wild spirits. Paralyzes, a hemiparesis, defeat of a facial and optic nerve are possible.
Encephalitis is shown also at patients with a rubella and chicken pox. In this case symptoms of a disease arise for 2-8 day. There is a defeat of a nervous system. The beginning of encephalitis – acute: paralyzes, paresis, epileptic attacks, hyperkinesias are possible. Coordination can be broken, and in certain cases there is a defeat of optic nerves.
The virus of herpes can provoke development of herpetic encephalitis. At this illness there is a defeat of a cerebral cortex and white matter. Gradually the focal or eurysynusic necrosis develops. This type of encephalitis is considered slowly developing infection in view of the fact that the virus can remain in an organism throughout long time. A way of penetration of a virus to a nervous system – hematogenous, and also on perineural spaces. High temperature of a body, epileptic seizures, vomiting, a headache and other symptoms is characteristic of an acute form of an illness. If development of necrotic encephalitis takes place, then there are catarral phenomena. Seven days later there is a sharp rise in body temperature, and there are symptoms of defeat of a nervous system characteristic of other forms of encephalitis. Especially hard this form of encephalitis at children proceeds.
Definition "polyseasonal encephalitis" is applied to definition of group of the encephalitis having the obscure etiology. Most often at this type of an illness cerebellar, stem, polusharny syndromes are shown. At a cerebellar syndrome coordination and gait is broken, there are other disturbances. At a trunk syndrome there is a change of functions of the facial, oculomotor and taking-away nerves. Emergence of vestibular and bulbar frustration is possible.
Epileptic seizures, paresis, paralysis are feature of a polusharny syndrome. Also serious violations of consciousness are possible.
Less often toksoplazmozny encephalitis can meet. At its acute form the body temperature, pneumonia, conjunctivitis, myocarditis, skin a dieback, pharyngitis increases.
Diagnosis of encephalitis
As diagnostic methods of encephalitis of different forms research of cerebrospinal liquid is used. At encephalitis in it the lymphocytic pleocytosis, moderate increase of level of protein is observed. The effluence of liquor occurs at supertension. Also blood test is made. At encephalitis increase in SOE, a leukocytosis is observed. At research EEG available diffusion nonspecific changes. At a magnetic and resonant tomography gipodensny local changes of a brain come to light. Except the specified researches bacteriological and serological researches for identification of a virus – a disease-producing factor are conducted.
Treatment of encephalitis
After the diagnosis "encephalitis" is established, the patient needs to be placed immediately in a hospital – in neurology or infectious unit. It is important to patient to observe the most strict bed rest and to be under a constant control of the specialist.
At the first stage of treatment dehydrational means are applied. If at the patient pronounced meningeal and encephalitic signs (especially severe headaches and muscle pains, vomiting, toxicosis) take place, to it appoint administration of isotonic solution of sodium of chloride. Also in parallel with the specified drugs ascorbic acid, vitamins of group B are appointed.
During the acute period of an illness interferon and those drugs which activate its development is applied to treatment; are used at treatment and the desensibilizing means.
At therapy of a tick-borne encephalitis in the acute period of an illness apply Prednisolonum, gamma-globulin, and also enter the inactivated cultural tick-borne encephalitis vaccine. At polyseasonal encephalitis immediate hospitalization is shown. Except the specified drugs at this form of an illness ribonuclease is applied.
To activate process of microcirculation and dehydration, at therapy of encephalitis use dextrans. At influenzal encephalitis glucocorticoids are successfully applied.
The patient with herpetic encephalitis appoint in the first days of treatment Curantyl, later – drugs of Viroleks, Levamisole, homological Gamma-globulin. The dosage of all specified drugs is defined individually.
Besides, at treatment of encephalitis antihistaminic drugs are used, and in case of emergence pribakterialny complications by the patient antibiotics are shown.
Prevention of encephalitis
The most efficient are prevention measures for the prevention of a disease of a tick-borne encephalitis. Before the forthcoming visit to places where there is especially high risk of infection with encephalitis, it is necessary to do vaccination surely. The encephalitis vaccine is entered a month before a trip. If the sting of a tick nevertheless took place, it is necessary to see as soon as possible a doctor and to receive an immunoglobulin inoculation. It is very important to put on correctly before a campaign in the wood or to the mountain and woody district. It is not necessary to leave open body parts, easily available to insects: the shirt has to have long dense sleeves, existence of a headdress is important. Also it is worth taking means against blood-sicking insects in a similar trip.
It is important to examine after a campaign in the wood: ticks especially often stick on a neck, in a groin, in auricles, in axillary area. It is not necessary to drink milk of animals who are in a zone of the increased risk of infection. The tick cannot be crushed, encephalitis can catch even in the presence of small cracks on hands.
If at the person the feeling sick after a trip to area with the encephalitis raised by risk of infection takes place, it is necessary to address the doctor immediately.
Section: Brain diseases