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)
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1
Q

hallmark symptoms of encephalitis in addition to headache and fever

A
  • brain dysfunction including…
  • depressed levels of consciousness
  • seizures
  • behavior changes
  • focal neurologic signs
2
Q

6 major causes of viral encephalitis

A

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

3
Q

how is specific cause of viral encephalitis determined

A
  • symptoms tend to all be the same so must use PCR, antigen detection etc.
4
Q

which type of viral encephalitis is usually epidemic?

A

arbovirus (arthropod borne)

5
Q

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

A

herpes (HSE)

6
Q

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

A

hsv-1

7
Q

HSE portal of entry

A
  • nasal mucosa

- trigeminal ganglion

8
Q

HSE where in the brain?

A

orbitofrontal and anteromedial temporal cortices

9
Q

HSE pathology

A
  • severe

- inflammation, edema, necrosis, hemorrhage

10
Q

HSE neurological symptoms

A
  • personality changes
  • memory loss
  • loss of smell and olfactory hallucinations
  • hemiparesis or aphasia are possible if unilateral
11
Q

HSE lab findings

A

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
Q

treatment of HSE

A
  • treat while waiting for PCR results

- acyclovir, start ASAP, benign medication

13
Q

most common arboviruses in US

A
  • eastern and western equine
  • St. Louis
  • California
  • West Nile
14
Q

arbovirus incubation period

A

2-18 days after mosquito bite

15
Q

seasonal incidence of arbovirus

A

late summer, early autumn

16
Q

rabies incubation period

A

up to one year

17
Q

parts of brain rabies tends to attack

A
  • limbic system
  • hypothalamic area
  • brain stem nuclei
18
Q

neurological signs of rabies encephalitis

A
  • agitated delirium
  • seizures
  • painful spasms of throat musculature
19
Q

treatment of rabies encephalitis

A
  • no treatment after neurological damage is done

- there is early immune treatment

20
Q

west nile and polio similarity

A
  • both can attack motor neurons of spinal cord and brain stem
21
Q

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

A

they cause subacute or chronic disease often after long latent period

22
Q

subacute sclerosing panencephalitis (SSPE) affects mainly whom?

A

children and adolescents

23
Q

SSPE disease progression

A

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

24
Q

SSPE CSF

A
  • high gamma globulin

- high measles antibody titer

25
Q

who gets progressive multifocal leukoencephalopathy (PML)?

A
  • the debilitated, mostly lymphoma and AIDS
26
Q

cause of PML

A

two different papovaviruses (one of which is JC virus)

27
Q

PML pathology

A
  • small areas of demyelination

- inclusion bodies seen in oligodendroglia

28
Q

PML disease progression

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