Viral Encefalitele

Viral Encefalitele

    * Introduction
    * Diagnostic Laboratory
    * Treatment
Encefalitele defined by having a viral infection of viral aetiology in cerebral parenchyma. Characteristic viral encefalitele is altered in varying degrees of consciousness and focal neurological deficits and diffuse appearance. Correct diagnosis is made by examination of cerebrospinal fluid (CSF) obtained by lumbar puncture and is more of a diagnosis of exclusion, because the culture of the CSF virus is very difficult. And antiviral treatment is supportive. Can not say that viral encephalitis is a severe disease, because clinical varies very widely depending on etiologic agent of disease and associated pathology of the patient. Generally patients affected eastern equine encephalitis virus heal with quite severe neurological sequelae, while patients affected by Epstein-Barr virus shows very rare neurological sequelae.
There are many viruses that cause viral encephalitis, which generally are the same and cause meningitis. The viruses that most commonly cause viral encephalitis are enteroviruses, arboviruses, herpes simplex virus type 1 and mumps. Viruses are rarely involved in encephalitis are adenovirusurile etilologia, citomegaliei virus, Epstein-Barr virus, HIV, rubella virus, measles and rabies, varicella-zoster virus, the virus of Colorado tick fever on. Viruses have a tropism for a specific region of the central nervous system and certain viruses affecting the well-established predilection regions of the brain. But only on the basis of clinical signs can not make a distinction between types of viruses responsible for the disease.
Clinical manifestations in viral encephalitis
Patients with viral meningitis shows a clinical picture dominated by disorders of consciousness. Consciousness is altered in very broad limits, ranging from mild confusion to coma entrance, depending on the patient's condition before the illness and the etiologic agent.
The neurological examination is clearly apparent that the patient is confused, disoriented and sometimes delireaza. Going to delirium or hallucinations visual aids. Agitation, comortament disorders and personality changes are common, especially if it affected the frontal lobe in particular. More than half of patients affected by seizures are focal or generalized nature. Neurological examination in May highlights and diffuse and focal neurological signs. The most common focal neurologic changes are aphasia, ataxia, hemiparesis with hyperactive tendon reflexes and extensor plantar response. It is also objectifies myoclonic contractions, involuntary, and cranial nerve impairment and oculomotor nerve palsy and cranianVII nerve (facial). In severe cases there may be a disease affecting the hypothalamic-pituitary axis leading to hormonal imbalances: diabetes insipidus, impaired body temperature (in the hypothalamus are temperature control centers). Diabetes insipidus is characterized by excessive thirst and urination in large amounts, the patient to drink 20 liters of water a day and still urinates on that. Diabetes insipidus has nothing to do with diabetes. Be established with certainty whether viral infection caused by Herpes simplex virus, because this is very important for therapy. Herpes simplex virus infection is suggested clinical implication fronto-temporal regions inferomediale brain, the patient complaining of olfactory and gustatory hallucinations, anosmia, has a bizarre behavior. Often meet and personality disorders, decreasing from work and impaired short-term memory.
Clinical symptoms is very suggestive of infection with Herpes simplex virus, but the ideal would be to highlight the virus in cerebrospinal fluid. However, Herpes simplex virus therapy can be initiated only on clinical signs, given the fact that viruses are difficult to obtain the CSF cultures.