Carol Kirrane Lecturer Practitioner ENCEPHALITIS Carol Kirrane Lecturer Practitioner

CONTENTS 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 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

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