Encephalitis (Hindi) : Internal Medicine

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Encephalitis

Encephalitis is an inflammation of the brain parenchyma, typically caused by viral infections such as herpes simplex virus (HSV), arboviruses (like West Nile virus), enteroviruses, and varicella-zoster virus (VZV), although bacteria, fungi, and autoimmune conditions can also be responsible. This condition can present as a primary infection, where the virus directly invades the brain, or as a post-infectious autoimmune response. The inflammation in encephalitis leads to brain swelling, neuronal damage, and potentially necrosis, exacerbated by the immune response, which produces cytokines and other inflammatory mediators. Clinically, encephalitis manifests with general symptoms like fever, headache, and fatigue, alongside neurological symptoms including altered mental status, confusion, seizures, and focal neurological deficits such as weakness or sensory changes. Behavioral changes like irritability, personality shifts, and hallucinations can also occur. Additional signs include nausea, vomiting, and photophobia (sensitivity to light). Diagnosis involves clinical evaluation, laboratory tests, and imaging studies. A lumbar puncture is performed to analyze cerebrospinal fluid (CSF), often showing elevated white blood cells, increased protein, and normal glucose levels in viral encephalitis, with PCR testing used to identify specific viral DNA or RNA. Imaging studies, particularly MRI, can reveal areas of inflammation or damage, while electroencephalography (EEG) may show abnormalities consistent with encephalitis. Treatment depends on the underlying cause; antiviral therapy, such as acyclovir, is crucial for HSV encephalitis and should be initiated promptly. Supportive care includes managing symptoms with antipyretics for fever, anticonvulsants for seizures, and corticosteroids to reduce brain swelling in certain cases. Immunomodulatory treatments may be considered for autoimmune encephalitis. Early diagnosis and prompt treatment are essential to reduce morbidity and mortality associated with encephalitis. 🌟🧠💉

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