1. Carol Kirrane Lecturer Practitioner
ENCEPHALITIS
Carol Kirrane
Lecturer Practitioner

2. CONTENTS A&P Facts about encephalitis Signs & Symptoms Contagiousness
Diagnosis
Treatment

3. 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

4. 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

5. 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

6. 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

7. 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

8. 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

9. 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)

10. 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

11. 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

12. 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

13. 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

14. 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

15. The Encephalitis Society
Based in Malton North Yorkshire open Mon- Fri 9-5pm
Tel
Give info & direct support for Pts and carers

16. 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

17. QUESTIONS???????????????