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To distinguish encephalitis primary and secondary . In turn, the primary type of the disease includes a number of types of encephalitis: tick . epidemic . Enterovirus . mosquito . herpetic etc. Encephalitis secondary seen against the background of other diseases: Measles . Flu . abscess of the brain . toxoplasmosis and etc.
There is a classification of the disease according to its etiology and pathogenesis: to distinguish between encephalitis infectious . allergic . infectious-allergic . toxic . At polientsefalite gray matter of the brain is affected, with leykoeitsefalite - White matter. If a person takes the defeat of white and gray matter, in this case there is a panencephalitis .
There are also diffuse and limited encephalitis, and according to the course of the disease is divided into sharp . subacute and chronic encephalitis.
Epidemic encephalitis
The disease is caused by exposure to virus filter. Infection occurs contact or by airborne droplets. In this case, the incubation period may last from days to two weeks. The virus enters the body and affects the brain. The substance and the lining of the brain is the development of inflammation, manifested hyperemia . In the acute phase of the disease in man increases suddenly body temperature to 38 ° C. If the affected centers of thermoregulation, the temperature can be higher. As the main symptom epidemic encephalitis a person observed a pronounced sleep disturbance: a person is always in drowsy or suffer from insomnia. There may be as daytime sleepiness and lack of sleep at night. As other symptoms of encephalitis note occurrence oculomotor disorders, inflammatory reactions of blood nonspecific. The acute phase of the illness lasts about two to three weeks, then about half the people recover completely or partially. Another 50% of cases the disease becomes chronic. In this case, the symptoms of encephalitis similar to the signs of shaking palsy. Also, a person may show changes in the psyche. In the chronic form of the disease may progress to encephalitis, which occurs as a result of disability.
For the treatment of epidemic encephalitis often prescribed drugs with antiviral effect, dehydrating and desensitizing agents, vitamins.
Tick borne encephalitis
Tick-borne encephalitis has several clinical forms: poliomieliticheskaya . meningeal . polioentsefalomieliticheskaya . Cerebral and erased .
At meningeal form of encephalitis manifested pronounced meningeal symptoms. In humans, due to inflammation of the brain and its membranes there are disorders of consciousness, seizures, delirium, paralysis . There are signs of a seizure with a probability of transition to the common seizure.
When encephalitis polioentsefalomieliticheskoy form the patient appears flaccid paralysis of muscles of the shoulder girdle and neck. Perhaps the manifestation of shell and bulbar disorders.
Patients with polnomieliticheskoy a form of encephalitis symptoms as paresis and paralysis of the neck, arms, patient unnatural head hanging on his chest. The sensitivity of a man is not broken, but manifest failure of motor functions. At erased form of tick-borne encephalitis for two-four days the patient is fever , Neurological symptoms appear, but there is tachycardia , Periodic bouts of hypertension. Also released progredient form of the disease, in which the observed periodic twitching of certain muscle groups. Basically it is the muscles of the arms and neck.
Japanese encephalitis
Japanese encephalitis (another name - encephalitis ) Provokes the virus, which is stored and transferred by mosquitoes. Carriers of the virus can sometimes be a bird, people. In this case, the incubation period lasts from three to twenty-seven days. The disease begins to manifest itself in dire: the body temperature rises sharply to 40 ° C and above are not falling for about 10 days. The patient was plagued by malaise, fever, weakness, severe headache, vomiting, muscle aches. There hyperthermia skin, dry tongue much pulled stomach. There may be abnormalities in heart and in the mind of the patient. There is increased flexor tone of the upper limbs and lower limbs while the extensors. Sometimes it occurs some muscle twitching, recurrent seizures. In severe disease may manifest bulbar paralysis. In this disease, death occurs in about 50% of cases.
Other forms of encephalitis
To meningoencephalitis characteristic manifestation of paresis, paralysis, coma, and in some cases may experience epileptic seizures. At to Orewa encephalitis e, which can develop about 3-5 days after the patient manifests rash, loss occurs mostly white solid as the brain and spinal cord. With the development of this form of encephalitis patients condition deteriorates again, increases the body temperature. The symptoms of encephalitis in this case may be different. For example, some patients complain of general weakness, drowsiness, which may go into a coma. Other patients experience delusions and impaired consciousness, seizures, they may occasionally remain in the excited state. There may be paralysis, hemiparesis, loss of facial and optic nerve.
Encephalitis is also seen in patients Rubella and chickenpox. In this case, the symptoms of the disease appear on the 2-8 day. There is damage to the nervous system. Home encephalitis - acute: possible paralysis, paresis, seizures, hyperkinesis. Can disturbed coordination and, in some cases there is optic nerve damage.
Virus Herpes can trigger the development of herpes encephalitis . When this illness occurs defeat the cerebral cortex and white matter. Gradually develops focal or widespread necrosis. This type of encephalitis is considered to be slowly developing infection because the virus can persist in the body for a long time. The way the virus enters the nervous system - hematogenous, as well as perineural spaces. For the acute form of the disease characterized by high fever, seizures, vomiting, headache and other symptoms. If there is a development of necrotizing encephalitis is present catarrhal phenomena. After seven days there is a sharp rise in body temperature, and there are symptoms of nervous system characteristic of other forms of encephalitis. Especially hard this form of encephalitis occurs in children.
The definition of " polisezonny encephalitis "Is used to define the group of encephalitis, with unknown etiology. Most often, this type of the disease manifest cerebellar, stem, hemispheric syndromes. When cerebellar syndrome impaired coordination and gait, there are other violations. When there is a change-stem syndrome features facial, oculomotor and abducens. Perhaps the emergence of bulbar and vestibular disorders.
Epileptic seizures, paresis, paralysis, are a feature of hemispheric syndrome. There are also serious violations of consciousness.
Rarely can occur toxoplasmosis encephalitis . In the acute form it increases the body temperature, pneumonia, conjunctivitis, myocarditis, skin exanthema, pharyngitis .
Diagnosis of encephalitis
As diagnostic methods use various forms of encephalitis study of cerebrospinal fluid. When it is observed encephalitis lymphocytic pleocytosis, a moderate increase in protein levels. Streaming CSF It takes place at elevated pressure. It also involves a blood test. When encephalitis, an increase of ESR, leukocytosis. In the study of EEG in stock diffuse nonspecific changes. Magnetic resonance imaging revealed hypodense local changes in the brain. In addition to the research conducted bacteriological and serological tests to identify the virus - the causative agent.
Treatment for encephalitis
At the first stage of treatment used dehydration means. If the patient occur pronounced meningeal and encephalitic evidence (especially severe headaches and muscle pain, vomiting, toxemia ), It is prescribed isotonic sodium chloride solution. Also, in parallel with these drugs are prescribed a skorbinovaya acid . B vitamins .
In the acute phase of the disease to treat is used interferon and those drugs that activate its production; used in the treatment and desensitizing agents.
In therapy tick-borne encephalitis in the acute stage of the disease used prednisolone . gamma globulin And introduced the culture inactivated vaccine against tick-borne encephalitis. When polisezonnym encephalitis shows immediate hospitalization. In addition to these drugs for this form of the disease is used ribonuclease .
If the patient is a serious condition, immediate measures are taken intensive care. In the case of an epileptic seizure, the introduction of the drug seduksen ( relanium ).
In order to intensify the process of microcirculation and dehydration, for the treatment of encephalitis using dextran. When influenza encephalitis successfully used steroids.
Patients with herpes encephalitis appointed in the first days of treatment Curantylum Later - drugs viroleks . levamisole . homologous gamma globulin . The dosage of these drugs is determined individually.
Furthermore, in the treatment of encephalitis applied antihistamines And in case of complications, patients are shown pribakterialnyh antibiotics .
Prevention Encephalitis
The most effective prevention is to prevent tick-borne encephalitis. Before the upcoming visit to the place where there is a particularly high risk of infection encephalitis, you must be sure to get vaccinated. Encephalitis vaccine is administered a month before the trip. If the tick bite yet occurred, you need as quickly as possible to see a doctor and get vaccinated immunoglobulin. It is important to dress properly before going into the woods or in the mountains and forests. Do not leave open easily accessible insect parts of the body: the shirt should be long tight sleeves, it is important the presence of headgear. Also, such a trip is worth taking anti-blood-sucking insects.
It is important to inspect after a hike in the woods: ticks most often attach themselves to the neck, in the groin, in the ears, in the armpit. Do not drink the milk of animals that are at high risk of infection. You can not crush the tick because encephalitis can be transmitted even if there are small cracks on their hands.
If a person has a place of feeling unwell after a trip to the region with an increased risk of infection encephalitis should immediately consult a doctor.
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