logging in or signing up Encephalitis neurology1 Download Post to : URL : Related Presentations : Share Add to Flag Embed Email Send to Blogs and Networks Add to Channel Uploaded from authorPOINT lite Insert YouTube videos in PowerPont slides with aS Desktop Copy embed code: (To copy code, click on the text box) Embed: URL: Thumbnail: WordPress Embed Customize Embed The presentation is successfully added In Your Favorites. Views: 163 Category: Science & Tech.. License: All Rights Reserved Like it (1) Dislike it (0) Added: February 26, 2011 This Presentation is Public Favorites: 0 Presentation Description No description available. Comments Posting comment... By: neurology1 (13 month(s) ago) You can download it from authorstream. I have enabled download. regards. Saving..... Post Reply Close Saving..... Edit Comment Close Premium member Presentation Transcript Encephalitis: Encephalitis Dr Rahul Chakor Lecturer – Neurology T. N. Medical. College B. Y. L. Nair Hospital MumbaiEncephalitis: Encephalitis Inflammation of the cerebral parenchyma, meninges – Meningoencephalitis Gray Matter, White matter, Gray – white junction, gray matter nuclei, brainstemEncephalitis: Encephalitis Blood borne Retrograde neuro-axonal Neuronal receptorsEncephalitis: Encephalitis Numerous viruses Infective microorganisms - bacteria, fungii, parasites Drugs (NSAIDs) Autoimmune disorders - SLE, vasculitis Postinfective - ADEMViral Encephalitis: Viral Encephalitis Herpesviruses HSV 1 and 2 Varicella zoster CMV Arboviruses Japanese virus Eastern equine virus Western equine virus West Nile Enteroviruses Coxackie Echo Adenoviruses HIV Measles Mumps Rabies NippahEncephalitis: Encephalitis Bacterial TB Listeria Whipple disease Rickettsia Syphilis LymeEtiology: Etiology Fungi Cryptococcosis Parasites Toxoplasmosis Malaria Cysticercosis Paraneoplastic Limbic, brainstemHerpes Encephalitis: Herpes Encephalitis HSV 1 (oral mucosa) – a common cause HSV 2 (genital infection) – neonatal Most common cause of sporadic viral encephalitisHerpes Encephalitis: Herpes Encephalitis Pathogenesis - Virus latent in trigeminal ganglia, reactivated and spreads along olfactory tract - Virus spreads along nerve fibers innervating meninges of anterior and middle fossaeHerpes Encephalitis: Herpes Encephalitis Pathology Intense inflammation, necrosis, ( necrotizing encephalitis ) Hemorrhagic lesions in the medial temporal lobes, medial frontal and orbitofrontal regions, Cingulate gyrus, Insular cortex, lateral temporal lobes, midbrain, ponsSymptoms: Symptoms Evolve over several days or acutely Fever, headache, confusion, stupor, coma (temporal lobe swelling & uncal herniation) Seizures, status epilepticus Psychotic behavior, personality changes, irritability delirium Temporal lobe seizures - Gustatory or olfactory hallucinations, anosmiaDiagnosis: Diagnosis CSF Increased pressure, pleocytosis (10 – 500 cells/mm 3 ) lymphocytes, normal initially, RBCs, xanthocromia, raised proteins, normal glucose, HSV antigen, DNA, detection by PCRDiagnosis: Diagnosis Neuroimaging CT scan – Hypodensity in 50 – 60 % of cases MRI – Increased T2 signal in > 90% cases Contrast enhancementSlide 14: Herpes EncephalitisSlide 15: MRI – Herpes EncephalitisEEG: EEG PLEDsSlide 17: PathologyDifferential diagnosis : Differential diagnosis ADEM Cerebral venous thrombosis Subdural Empyma Cerebral Abscess Septic EmbolismTreatment: Treatment General Medical Care Increased ICP – Head elevation, diuretic, steroids, mannitol, hyperventilation Seizures – Phenytoin, Carbamazepine, BenzodiazepineTreatment: IV Acyclovir 10mg/kg tid for 14 days in any proven or suspected case of Herpes Encephalitis Adverse effects – IV irritation, renal dysfunction TreatmentTreatment: Outcome Depends on age and level of consciousness Survival more than 90% when treatment begun within 4 days of onset in conscious patient Squelae – Dementia, temporal lobe epilepsy, Korsakoff amnesic syndrome TreatmentTHANK YOU: THANK YOU You do not have the permission to view this presentation. In order to view it, please contact the author of the presentation.
Encephalitis neurology1 Download Post to : URL : Related Presentations : Share Add to Flag Embed Email Send to Blogs and Networks Add to Channel Uploaded from authorPOINT lite Insert YouTube videos in PowerPont slides with aS Desktop Copy embed code: (To copy code, click on the text box) Embed: URL: Thumbnail: WordPress Embed Customize Embed The presentation is successfully added In Your Favorites. Views: 163 Category: Science & Tech.. License: All Rights Reserved Like it (1) Dislike it (0) Added: February 26, 2011 This Presentation is Public Favorites: 0 Presentation Description No description available. Comments Posting comment... By: neurology1 (13 month(s) ago) You can download it from authorstream. I have enabled download. regards. Saving..... Post Reply Close Saving..... Edit Comment Close Premium member Presentation Transcript Encephalitis: Encephalitis Dr Rahul Chakor Lecturer – Neurology T. N. Medical. College B. Y. L. Nair Hospital MumbaiEncephalitis: Encephalitis Inflammation of the cerebral parenchyma, meninges – Meningoencephalitis Gray Matter, White matter, Gray – white junction, gray matter nuclei, brainstemEncephalitis: Encephalitis Blood borne Retrograde neuro-axonal Neuronal receptorsEncephalitis: Encephalitis Numerous viruses Infective microorganisms - bacteria, fungii, parasites Drugs (NSAIDs) Autoimmune disorders - SLE, vasculitis Postinfective - ADEMViral Encephalitis: Viral Encephalitis Herpesviruses HSV 1 and 2 Varicella zoster CMV Arboviruses Japanese virus Eastern equine virus Western equine virus West Nile Enteroviruses Coxackie Echo Adenoviruses HIV Measles Mumps Rabies NippahEncephalitis: Encephalitis Bacterial TB Listeria Whipple disease Rickettsia Syphilis LymeEtiology: Etiology Fungi Cryptococcosis Parasites Toxoplasmosis Malaria Cysticercosis Paraneoplastic Limbic, brainstemHerpes Encephalitis: Herpes Encephalitis HSV 1 (oral mucosa) – a common cause HSV 2 (genital infection) – neonatal Most common cause of sporadic viral encephalitisHerpes Encephalitis: Herpes Encephalitis Pathogenesis - Virus latent in trigeminal ganglia, reactivated and spreads along olfactory tract - Virus spreads along nerve fibers innervating meninges of anterior and middle fossaeHerpes Encephalitis: Herpes Encephalitis Pathology Intense inflammation, necrosis, ( necrotizing encephalitis ) Hemorrhagic lesions in the medial temporal lobes, medial frontal and orbitofrontal regions, Cingulate gyrus, Insular cortex, lateral temporal lobes, midbrain, ponsSymptoms: Symptoms Evolve over several days or acutely Fever, headache, confusion, stupor, coma (temporal lobe swelling & uncal herniation) Seizures, status epilepticus Psychotic behavior, personality changes, irritability delirium Temporal lobe seizures - Gustatory or olfactory hallucinations, anosmiaDiagnosis: Diagnosis CSF Increased pressure, pleocytosis (10 – 500 cells/mm 3 ) lymphocytes, normal initially, RBCs, xanthocromia, raised proteins, normal glucose, HSV antigen, DNA, detection by PCRDiagnosis: Diagnosis Neuroimaging CT scan – Hypodensity in 50 – 60 % of cases MRI – Increased T2 signal in > 90% cases Contrast enhancementSlide 14: Herpes EncephalitisSlide 15: MRI – Herpes EncephalitisEEG: EEG PLEDsSlide 17: PathologyDifferential diagnosis : Differential diagnosis ADEM Cerebral venous thrombosis Subdural Empyma Cerebral Abscess Septic EmbolismTreatment: Treatment General Medical Care Increased ICP – Head elevation, diuretic, steroids, mannitol, hyperventilation Seizures – Phenytoin, Carbamazepine, BenzodiazepineTreatment: IV Acyclovir 10mg/kg tid for 14 days in any proven or suspected case of Herpes Encephalitis Adverse effects – IV irritation, renal dysfunction TreatmentTreatment: Outcome Depends on age and level of consciousness Survival more than 90% when treatment begun within 4 days of onset in conscious patient Squelae – Dementia, temporal lobe epilepsy, Korsakoff amnesic syndrome TreatmentTHANK YOU: THANK YOU