Viral encephalitides

Viral encephalitidesVIRAL ENCEPHALITIDES is a group of diseases characterized by inflammation of the brain and caused by neurotropic viruses. Etiology, pathogenesis. With the introduction of the virus arise destruction of neurons, swelling of brain tissue, arteritis and thrombosis of small vessels, proliferation of glia. Brain damage can be diffuse (encephalomyelitis), election (paleoencephalon) or local. Generally, the process involved and the meninges. Vernal (spring-summer encephalitis. The virus is transmitted by Ixodes ticks, the distribution of which is limited Far East, Siberia, the Urals and to a lesser extent the Central regions of the country, Belarus and Baltic States. In addition to infection with the tick bite infection is possible through nutritional through the milk of goats and cows. The disease usually occurs in the spring and summer. As with other CNS, the severity of the clinical picture and the prevalence of lesions of certain parts of the nervous system vary from mild nonspecific febrile States or serous meningitis to severe meningoencephalitis ending lethal. The most typical pattern of lesions of the gray matter of the brainstem and cervical spinal cord. On the background of acute obstipation syndromic develop bulbar disorders and flaccid paralysis of the neck and upper extremities. Usually seen and meningeal symptoms. In severe cases, there are stunning, delusions, hallucinations. The temperature begins to decrease at 5-7-th day of the disease, then subside cerebral signs, softened focal symptoms. Blood examination in the acute period reveals leukocytosis, increased ESR: in the cerebrospinal fluid of moderate Placitas. The differential diagnosis reference points are endemic tick-borne encephalitis, it is confined to a specific period of the year, the positive reaction of complement fixation (RAC) and the reaction of neutralization. Treatment. Donor gamma-globulin/m 6-9 ml, and in severe forms 6 ml 2 times a day; serum polyglobulia 6-9 ml/m; encephalitis immunoglobulin 3-6 ml 2 times a day in severe cases of 12 ml. Massive doses of glucocorticoids. For the purpose of protection from superinfection prescribe antibiotics. According to the indications prescribed symptomatic treatment. When residual defects do rehabilitation therapy. The forecast. Mortality from 10% to 20%. In recent years, dominated by a relatively mild form of the disease. May be complete recovery or recovery with a neurological defect most often in the form of weakness and loss of muscle of neck, hands, belt upper extremities. Prevention. Specific vaccination in a special pattern. Protective measures against tick bites. Mosquito (Japanese) encephalitis. Pathogen-specific virus, portable special species of mosquitoes. Disease within the USSR is recorded only in the far East and has a pronounced seasonality (summer-autumn period). For the clinical picture characterized by the severity of encephalopathy syndrome, deep dizziness. High blood leukocytosis. Mortality in individual bursts up to 10%; complete recovery occurs in half of cases. The acute phase of lethargic encephalitis, Economo referred to as gipertoniceskaja ophthalmoplegia. True cases of Economo now, apparently, do not occur. Encephalitides (meningoencephalomyelitis) preinfection and post-vaccination. Etiology, pathogenesis. Crucial allergic mechanisms. Preinfection complications of the nervous system are observed almost in all known infections. Neurological syndrome preinfection and post-vaccination complications, as a rule, does not have any specific signs, its nature depends on the underlying disease. Encephalomyelitis with rabies vaccinations. Usually ascertain 2-3 cases of neurological complications per 10 thousand people who received rabies vaccine. Polarisavenue disseminated encephalomyelitis usually occurs after multiple injections of rabies vaccine. Especially a natural development in a similar situation transverse myelitis on the background of concomitant lesions of various parts of the brain. Symptomatic treatment: apply large doses of glucocorticoid hormones. In severe cases, prescribe antibiotics to prevent superinfection..



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