Christina Leanos
Sherry Ann
General Medical Words
WEEK 6
Encephalitis-Encephalitis is irritation and swelling (inflammation) of the brain, most
often due to infections.
Causes, incidence, and risk factors
Encephalitis is a rare condition. It occurs more often in the first year of life and
decreases with age. The very young and the elderly are more likely to have a severe
case.
Encephalitis is most often caused by a viral infection. Many types of viruses may
cause it. Exposure to viruses can occur through:
• Breathing in respiratory droplets from an infected person
• Contaminated food or drink
• Mosquito, tick, and other insect bites
• Skin contact
Different viruses will occur in different locations. Many cases will tend to cluster in a
certain season.
Encephalitis caused by the herpes simplex virus is the leading cause of more severe
cases in all ages, including newborns.
Symptoms
Some patients may have symptoms of a cold or stomach infection before
encephalitis symptoms begin.
When a case of encephalitis is not very severe, the symptoms may be similar to
those of other illnesses, including:
• Fever that is not very high
• Mild headache
• Low energy and a poor appetite
Other symptoms include:
• Clumsiness, unsteady gait
• Confusion, disorientation
• Drowsiness
• Irritability or poor temper control
• Light sensitivity
• Stiff neck and back (occasionally)
• Vomiting
Symptoms in newborns and younger infants may not be as easy to recognize:
• Body stiffness
• Irritability and crying more often (these symptoms may get worse when the
baby is picked up)
• Poor feeding
• Soft spot on the top of the head may bulge out more
• Vomiting
Emergency symptoms:
• Loss of consciousness, poor responsiveness, stupor, coma
• Muscle weakness or paralysis
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Seizures
Severe headache
Sudden change in mental functions:
• "Flat" mood, lack of mood, or mood that is inappropriate for the
situation
• Impaired judgment
• Inflexibility, extreme self-centeredness, inability to make a decision,
or withdrawal from social interaction
• Less interest in daily activities
Memory loss (amnesia), impaired short-term or long-term memory
Treatment/Medication
The goals of treatment are to provide supportive care (rest, nutrition, fluids) to help
the body fight the infection, and to relieve symptoms. Reorientation and emotional
support for confused or delirious people may be helpful.
Medications may include:
• Antiviral medications, such as acyclovir (Zovirax) and foscarnet (Foscavir) -to treat herpes encephalitis or other severe viral infections (however, no
specific antiviral drugs are available to fight encephalitis)
• Antibiotics -- if the infection is caused by certain bacteria
• Anti-seizure medications (such as phenytoin) -- to prevent seizures
• Steroids (such as dexamethasone) -- to reduce brain swelling (in rare cases)
• Sedatives -- to treat irritability or restlessness
• Acetaminophen -- for fever and headache
If brain function is severely affected, interventions like physical therapy and speech
therapy may be needed after the illness is controlled.
Aseptic Meningitis-Aseptic meningitis is an illness that appears similar to bacterial
meningitis. However, bacteria do not grow in cultures of the fluid around the brain
and spinal cord (cerebrospinal fluid). This may occur because there are no bacteria,
or because the bacteria are difficult to grow.
Causes, incidence, and risk factors
There are many causes of aseptic meningitis, including:
• Cancer (causes a syndrome similar to meningitis)
• Infections near the brain or spinal cord, such as epidural abscesses
• Fungi
• Medications (cause a syndrome similar to meningitis)
• Mycobacteria (nontuberculous)
• Syphilis
• Tick-borne diseases (such as Lyme disease)
• Tuberculosis
• Viruses
About half of aseptic meningitis cases are caused by coxsackie virus or echovirus,
two members of the enterovirus family. The rate of enteroviral infections increases
in the summer and early fall. Enteroviruses are spread by hand-to-mouth contact
and coughing. They also may be spread by contact with fecal matter.
Other viruses that cause this condition include:
• Chickenpox (varicella virus)
• Other enteroviruses
• Herpes simplex viruses, usually type 2
• HIV (especially acute HIV syndrome)
• Mumps
• Rabies virus
• West Nile virus
Risk factors for aseptic meningitis include:
• Being a health care worker
• Having a weakened immune system
• Exposure to children in a day care setting
• Exposure to someone with a recent viral infection
Symptoms
• Abdominal pain
• Abnormal sensitivity to light (photophobia)
• Chills
• Confusion
• Drowsiness
• Fever
• General discomfort, uneasiness, or ill feeling (malaise)
• Headache
• Muscle pain
• Nausea and vomiting
• Rash
• Sore throat
• Stiff neck
Signs and tests
Physical examination may show:
• Fast heart rate
• Fever
• Stiff neck
For any patient who is suspected of having meningitis, it is important to perform a
lumbar puncture ("spinal tap"), in which spinal fluid (known as cerebrospinal fluid,
or CSF) is collected for testing.
Tests that may be done include:
• Blood culture
• Chest x-ray
• CSF examination for cell count, glucose, and protein
• CT scan of the head
• Gram stain, other special stains, and culture of CSF
• Polymerase chain reaction (PCR) of CSF
Treatment/Medication
Treatment is needed for fungal or mycobacterial causes of aseptic meningitis.
Herpesvirus or varicella (chickenpox) virus may be treated with antiviral medicines.
Treatment for noninfectious causes consists of pain medications and managing
complications, if they occur.
No specific treatment is available for enteroviral or most other viral forms of aseptic
meningitis.
AT information
To reduce the risk of developing an infection that can become meningitis:
• Get vaccinated (against mumps or chickenpox, for example)
• Practice good hand washing
Practice other general good health measures
Headaches-Whether they're pounding and throbbing or dull and aching, headaches
are common in kids. Headaches can have a wide range of causes and many levels of
severity. It's important to understand how to recognize when a headache is just a
passing pain and when it's something more and requires medical attention.
Causes/Signs and symptoms
Headaches are thought to be caused by changes in chemicals, nerves, or blood
vessels in the area. These changes send pain messages to the brain and bring on a
headache.
In general, kids get the same types of headaches as adults. And headaches often are
hereditary, so if a parent gets them, their kids might too.
Some of the many potential headache triggers include:
• certain medications (headaches are a potential side effect of some)
• too little sleep or sudden changes in sleep patterns
• skipping meals
• becoming dehydrated
• being under a lot of stress
• having a minor head injury
• using the computer or watching TV for a long time
• vision problems
• menstruation
• experiencing changes in hormone levels
• taking a long trip in a car or bus
• listening to really loud music
• smoking
• smelling strong odors such as perfume, smoke, fumes, or a new car or carpet
• drinking or eating too much caffeine (in soda, coffee, tea, and chocolate)
• consuming certain foods (such as alcohol, cheese, nuts, pizza, chocolate, ice
cream, fatty or fried food, lunchmeats, hot dogs, yogurt, aspartame, or
anything with the food additive MSG)
In some cases, headaches are caused by certain infections, such as:
• ear infections
• viral infections, like the flu or common cold
• strep throat
• sinus infections
• Lyme disease
Most headaches aren't signs that something more is wrong, but occasionally
headaches are caused by more serious medical conditions.
AT informationThe AT needs to be aware of any history of head injuries and any infections
Epilepsy-Epilepsy is a brain disorder in which a person has repeated seizures
(convulsions) over time. Seizures are episodes of disturbed brain activity that cause
changes in attention or behavior.
Causes, incidence, and risk factors
Epilepsy occurs when permanent changes in brain tissue cause the brain to be too
excitable or jumpy. The brain sends out abnormal signals. This results in repeated,
unpredictable seizures. (A single seizure that does not happen again is not epilepsy.)
Epilepsy may be due to a medical condition or injury that affects the brain, or the
cause may be unknown (idiopathic).
Common causes of epilepsy include:
• Stroke or transient ischemic attack (TIA)
• Dementia, such as Alzheimer's disease
• Traumatic brain injury
• Infections, including brain abscess, meningitis, encephalitis, and AIDS
• Brain problems that are present at birth (congenital brain defect)
• Brain injury that occurs during or near bith
• Metabolism disorders that a child may be born with (such as
phenylketonuria)
• Brain tumor
• Abnormal blood vessels in the brain
• Other illness that damage or destroy brain tissue
Epilepsy seizures usually begin between ages 5 and 20, but they can happen at any
age. There may be a family history of seizures or epilepsy.
Symptoms
Symptoms vary from person to person. Some people may have simple staring spells,
while others have violent shaking and loss of alertness. The type of seizure depends
on the part of the brain affected and cause of epilepsy.
Most of the time, the seizure is similar to the previous one. Some people with
epilepsy have a strange sensation (such as tingling, smelling an odor that isn't
actually there, or emotional changes) before each seizure. This is called an aura.
For a detailed description of the symptoms associated with a specific type of seizure,
see:
• Absence (petit mal) seizure
• Generalized tonic-clonic (grand mal) seizure
• Partial (focal) seizure
Signs and tests
The doctor will perform a physical exam, which will include a detailed look at the
brain and nervous system.
An EEG (electroencephalogram) will be done to check the electrical activity in the
brain. People with epilepsy will often have abnormal electrical activity seen on this
test. In some cases, the test may show the area in the brain where the seizures start.
The brain may appear normal after a seizure or between seizures.
To diagnose epilepsy or plan for epilepsy surgery:
• You may need to wear an EEG recorder for days or weeks while you go about
your everyday life.
• You may need to stay in a special hospital where brain activity can be be
watched on video cameras. This is called video EEG.
Tests that may be done include:
• Blood chemistry
• Blood sugar
• CBC (complete blood count)
• Kidney function tests
• Liver function tests
• Lumbar puncture (spinal tap)
• Tests for infectious diseases
Head CT or MRI scan often done to find the cause and location of the problem in the
brain.
Treatment
Treatment for epilepsy may involve surgery or medication.
If epilepsy seizures are due to a tumor, abnormal blood vessels, or bleeding in the
brain, surgery to treat these disorders may make the seizures stop.
Medication to prevent seizures, called anticonvulsants, may reduce the number of
future seizures.
• These drugs are taken by mouth. Which type you are prescribed depends on
the type of seizures you have.
• Your dosage may need to be changed from time to time. You may need
regular blood tests to check for side effects.
• Always take your medication on time and as directed. Missing a dose can
cause you to have a seizure. Never not stop taking or change medications
without talking to your doctor first.
• Many epilepsy medications cause birth defects. Women wishing to become
pregnant should tell the doctor in advance in order to adjust medications.
Epilepsy that does not get better after two or three anti-seizure drugs have been
tried is called "medically refractory epilepsy."
• Surgery to remove the abnormal brain cells causing the seizures may be
helpful for some patients.
• Surgery to place a vagus nerve stimulator (VNS) may be recommended. This
device is similiar to a heart pacemaker. It can help reduce the number of
seizures.
Sometimes, children are placed on a special diet to help prevent seizures. The most
popular one is the ketogenic diet. A diet low in carbohydrates, such as the Atkins
diet, may also be helpful in some adults.
Lifestyle or medical changes can increase the risk for a seizure in a person with
epilepsy. Talk with your doctor about:
• New prescribed medications, vitamins, or supplements
• Emotional stress
• Illness, especially infection
• Lack of sleep
• Pregnancy
• Skipping doses of epilepsy medications
• Use of alcohol or other recreational drugs
Other considerations:
• Persons with epilepsy should wear medical alert jewelry so that prompt
medical treatment can be obtained if a seizure occurs.
• Persons with poorly controlled epilepsy should not drive. Each state has a
different law about which people with a history of seizures are allowed to
drive.
Also avoid machinery or activities where loss of awareness would cause great
danger, such as climbing to high places, biking, and swimming alone.
AT information-
Generally, there is no known way to prevent epilepsy. However, proper
diet and sleep, and staying away from illegal drugs and alcohol, may
decrease the likelihood of triggering seizures in people with epilepsy.
Reduce the risk of head injury by wearing helmets during risky activities;
this can help lessen the chance of developing epilepsy.
Persons with uncontrolled seizures should not drive. Each state has a
different law that determines which people with a history of seizures are
allowed to drive. If you have uncontrolled seizures, you should also avoid
activities where loss of awareness would cause great danger, such as
climbing to high places, biking, and swimming alone