infections of CNS - viral encephalitis and atypical conventional viral infections Flashcards Preview

SBM neurology > infections of CNS - viral encephalitis and atypical conventional viral infections > Flashcards

Flashcards in infections of CNS - viral encephalitis and atypical conventional viral infections Deck (28):
1

hallmark symptoms of encephalitis in addition to headache and fever

- brain dysfunction including...
- depressed levels of consciousness
- seizures
- behavior changes
- focal neurologic signs

2

6 major causes of viral encephalitis

1) arbovirus
2) picornavirus
3) myxovirus
4) herpes virus
5) pox virus
6) other

3

how is specific cause of viral encephalitis determined

- symptoms tend to all be the same so must use PCR, antigen detection etc.

4

which type of viral encephalitis is usually epidemic?

arbovirus (arthropod borne)

5

what is the most common non epidemic form of viral encephalitis?

herpes (HSE)

6

herpes encephalitis caused by hsv-1 or hsv-2?

hsv-1

7

HSE portal of entry

- nasal mucosa
- trigeminal ganglion

8

HSE where in the brain?

orbitofrontal and anteromedial temporal cortices

9

HSE pathology

- severe
- inflammation, edema, necrosis, hemorrhage

10

HSE neurological symptoms

- personality changes
- memory loss
- loss of smell and olfactory hallucinations
- hemiparesis or aphasia are possible if unilateral

11

HSE lab findings

CT - may show focal abnormality
MRI - may see changes sooner, but none specific to HSE
EEG - bitemporal slowing and sharp activity
PCR - most accurate and reliable

12

treatment of HSE

- treat while waiting for PCR results
- acyclovir, start ASAP, benign medication

13

most common arboviruses in US

- eastern and western equine
- St. Louis
- California
- West Nile

14

arbovirus incubation period

2-18 days after mosquito bite

15

seasonal incidence of arbovirus

late summer, early autumn

16

rabies incubation period

up to one year

17

parts of brain rabies tends to attack

- limbic system
- hypothalamic area
- brain stem nuclei

18

neurological signs of rabies encephalitis

- agitated delirium
- seizures
- painful spasms of throat musculature

19

treatment of rabies encephalitis

- no treatment after neurological damage is done
- there is early immune treatment

20

west nile and polio similarity

- both can attack motor neurons of spinal cord and brain stem

21

what is the primary difference between the atypical viral infections and the typical acute viral infections?

they cause subacute or chronic disease often after long latent period

22

subacute sclerosing panencephalitis (SSPE) affects mainly whom?

children and adolescents

23

SSPE disease progression

1) mental deterioration
2) myoclonic jerks
3) progressive pyramidal and extrapyramidal involvement
4) death within a few years

24

SSPE CSF

- high gamma globulin
- high measles antibody titer

25

who gets progressive multifocal leukoencephalopathy (PML)?

- the debilitated, mostly lymphoma and AIDS

26

cause of PML

two different papovaviruses (one of which is JC virus)

27

PML pathology

- small areas of demyelination
- inclusion bodies seen in oligodendroglia

28

PML disease progression

- starts with focal cortical signs and progresses to diffuse deterioration
- death in one to two years