Instructions for users. This slide presentation provides an overview of the clinical manifestations and diagnosis of encephalitis. Below many of the slides, there are notes to explain the information in the slide. You should adapt the presentation for your own use.
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Raj is a 5-year-old previously healthy boy who is brought in to his local health clinic by his mother with complaints of fever, poor appetite, and drowsiness.
Photo credit: Dr. JulieJacobson
Note: A single infection can affect multiple locations of the CNS, making clinical diagnosis difficult (i.e., meningomyeloencephalitis)
Inflammation of brain parenchyma secondary to infection is known as?
*Note: A large number of reported cases of encephalitis are due to an unspecified cause
Photo credit: Richard G. Weber
Which of the following is NOT a common cause of encephalitis?
Anyone can get encephalitis. However, the following groups are at higher risk:
Lethargy in the following clinical syndromes:
Change in consciousness
Vomiting and diarrhea
Tremors or convulsions
Common symptoms of encephalitis
The following are common symptoms of encephalitis in children, EXCEPT
When taking a history, it is important to remember the principles of good communication:
True or False. It is okay to skip the history if a family comes in and does not speak your native language.
Child with convulsions
The neurological exam in an encephalitis patient is part of the general physical examination. Thus, the neurologic exam should always be preceded by and interpreted in the context of a more general examination.
Testing facial nerve (VII)
Photo credit: Dr. Rao
Based on symptoms and signs:
Which of the following abnormalities in the neurological exam can be seen in a patient with encephalitis?
Photo credit: Dr. JulieJacobson
For surveillance purposes, WHO defines a case of acute encephalitis by:
* Simple febrile seizure: a single seizure lasting < 15 minutes with recovery of consciousness within 60 minutes, in a child aged 6 months to 5 years.
Which of the following is NOT part of the WHO case definition for acute encephalitis syndrome?
Normal with suspected encephalitis
Summary of typical CSF findings
CSF plasma : glucose ratio
Why is it important to perform a lumbar puncture on all suspected cases of encephalitis?
Which of the following are possible complications of encephalitis infection?
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Huang, C, Chatterjee, NK, Grady, LJ. Diagnosis of viral infections of the central nervous system. New England Journal of Medicine. 1999;340(6):483-484.
Kabilan L, Rajendran R, et al. Japanese encephalitis in India: An overview. Indian Journal of Pediatrics. 2004;71:609-615.
Mandell GL, Bennett JE, Dolin R, editors. Principles and practice of infectious diseases. Philadelphia: Churchill Livingstone; 2000.
National Institute of Neurological Disorders and Strokes (NINDS). Encephalitis and meningitis [fact sheet]. Bethesda: National Institute of Health; 2004. Available at: http://www.ninds.nih.gov/disorders/encephalitis_meningitis/detail_encephalitis_meningitis.htm
Roos KL. Encephalitis. Neurologic Clinics. 1999;17(4):813-33.
Solomon, T, Dung, NM, Kneen, R, et al. Seizures and raised intracranial pressure in Vietnamese patients with Japanese encephalitis. Brain. 2002; 125:1084-1093.
U.S. Centers for Disease Control and Prevention (CDC). Japanese encephalitis [fact sheet]. Fort Collins: CDC; 2004. Available at: http://www.cdc.gov/ncidod/dvbid/jencephalitis
Whitley, RJ. Viral encephalitis. New England Journal of Medicine. 1990;323(4):242-250.
Please include the following acknowledgement if you use this slide set:
This slide set was adapted from a slide set prepared by PATH’s Japanese Encephalitis Project.
For information: www.JEproject.org