ENCEPHALITIS
Carol Kirrane
Lecturer Practitioner
CONTENTS
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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
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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: mail@encephalitis.info
• 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???????????????