encephalitis

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Definition

Encephalitis is an inflammation of the brain, usually caused by a direct viral infection or a hypersensitivity reaction to a virus or foreign protein. Brain inflammation caused by a bacterial infection is sometimes called cerebritis. When both the brain and spinal cord are involved, the disorder is called encephalomyelitis. An inflammation of the brain's covering, or meninges, is called meningitis.

Description

Encephalitis is an inflammation of the brain. The inflammation is a reaction of the body's immune system to infection or invasion. During the inflammation, the brain's tissues become swollen. The combination of the infection and the immune reaction to it can cause headache and a fever, as well as more severe symptoms in some cases.

The viruses causing primary encephalitis can be epidemic or sporadic. The polio virus is an epidemic cause. Arthropod-borne viral encephalitis is responsible for most epidemic viral encephalitis. The viruses live in animal hosts and mosquitoes that transmit the disease. The most common form of non-epidemic or sporadic encephalitis is caused by the herpes simplex virus, type 1 (HSV-1) and has a high rate of death. Mumps is another example of a sporadic cause.

Demographics

Approximately 2,000 cases of encephalitis are reported to the Centers for Disease Control and Prevention in Atlanta, Georgia, each year. Encephalitis can strike anyone, at any age, although some kinds of encephalitis are more common in children. Other kinds of encephalitis can affect anyone, but may affect children more severely.

Causes and Symptoms

There are more than a dozen viruses that can cause encephalitis, spread by either human-to human contact or by animal bites. Encephalitis may occur with several common viral infections of childhood. Viruses and viral diseases that may cause encephalitis include:

• chickenpox
• measles
• mumps
• Epstein-Barr virus (EBV)
• cytomegalovirus infection
• HIV
• herpes simplex
• herpes zoster (shingles)
• herpes B
• polio
• rabies
• mosquito-borne viruses (arboviruses)

Primary encephalitis is caused by direct infection by the virus, while secondary encephalitis is due to a post-infectious immune reaction to viral infection elsewhere in the body. Secondary encephalitis may occur with measles, chickenpox, mumps, rubella, and EBV. In secondary encephalitis, symptoms usually begin five to ten days after the onset of the disease itself and are related to the breakdown of the myelin sheath that covers nerve fibers.

In rare cases, encephalitis may follow vaccination against some of the viral diseases listed above. Creutzfeldt-Jakob disease, a very rare brain disorder caused by an infectious particle called a prion, may also cause encephalitis.

Mosquitoes spread viruses responsible for equine encephalitis (eastern and western types), St. Louis encephalitis, California encephalitis, and Japanese encephalitis. Lyme disease, spread by ticks, can cause encephalitis, as can Colorado tick fever. Rabies is most often spread by animal bites from dogs, cats, mice, raccoons, squirrels, and bats and may cause encephalitis.

Equine encephalitis is carried by mosquitoes that do not normally bite humans but do bite horses and birds. It is occasionally picked up from these animals by mosquitoes that do bite humans. Japanese encephalitis and St. Louis encephalitis are also carried by mosquitoes. The risk of contracting a mosquito-borne virus is greatest in mid- to late summer, when mosquitoes are most active, in those rural areas where these viruses are known to exist. Eastern equine encephalitis occurs in eastern and southeastern United States; western equine and California encephalitis occur throughout the West; and St. Louis encephalitis occurs throughout the country. Japanese encephalitis does not occur in the United States but is found throughout much of Asia. The viruses responsible for these diseases are classified as arbovirus, and these diseases are collectively called arbovirus encephalitis.

Herpes simplex encephalitis, the most common form of sporadic encephalitis in western countries, is a disease with significantly high mortality. It occurs in children and adults and both sides of the brain are affected. It is theorized that brain infection is caused by the virus moving from a peripheral location to the brain via two nerves, the olfactory and the trigeminal (largest nerves in the skull).

Herpes simplex encephalitis is responsible for 10 percent of all encephalitis cases and is the main cause of sporadic, fatal encephalitis. In untreated people, the rate of death is 70 percent while the mortality is 15 to 20 percent in persons who have been treated with acyclovir. The symptoms of herpes simplex encephalitis are fever, rapidly disintegrating mental state, headache, and behavioral changes.

The symptoms of encephalitis range from very mild to very severe and may include:

• headache
• fever
• lethargy (sleepiness, decreased alertness, and fatigue)
• malaise
• nausea and vomiting
• visual disturbances
• tremor
• decreased consciousness (drowsiness, confusion, delirium, and unconsciousness)
• stiff neck
• seizures

Symptoms may progress rapidly, changing from mild to severe within several days or even several hours.

When to Call the Doctor

A physician should be called whenever a headache does not respond to medication or when a person experiences a fever over 104°F (40.0°C), nausea and vomiting, visual disturbances, a stiff neck, or seizures.

A doctor should be called when an infant's temperature rises above 100°F (37.8°C) and cannot be brought down within a few minutes. Infants whose temperatures exceed 102°F (38.9°C) should be sponge-bathed in cool water while waiting for emergency help to arrive.

Diagnosis

Diagnosis of encephalitis includes careful questioning to determine possible exposure to viral sources. Tests that can help confirm the diagnosis and rule out other disorders include:

• blood tests (to detect antibodies to viral antigens and foreign proteins)
• cerebrospinal fluid analysis, or spinal tap (to detect viral antigens and provide culture specimens for the virus or bacteria that may be present in the cerebrospinal fluid)
• electroencephalogram (EEG)
• CT and MRI scans

A brain biopsy (surgical gathering of a small tissue sample) may be recommended in some cases in which treatment has thus far been ineffective and the cause of the encephalitis is unclear. Definite diagnosis by biopsy may allow specific treatment that would otherwise be too risky.

Treatment

Choice of treatment for encephalitis depends on the cause. Bacterial encephalitis is treated with antibiotics. Viral encephalitis is usually treated with antiviral drugs, including acyclovir, ganciclovir, foscarnet, ribavirin, and AZT. Viruses that respond to acyclovir include herpes simplex, the most common cause of sporadic (non-epidemic) encephalitis in the United States.

The symptoms of encephalitis may be treated with a number of different drugs. Corticosteroids, including prednisone and dexamethasone, are sometimes prescribed to reduce inflammation and brain swelling. Anticonvulsant drugs, including phenytoin, are used to control seizures. Fever may be reduced with acetaminophen or other fever-reducing drugs.

A person with encephalitis must be monitored carefully, since symptoms may change rapidly. Blood tests may be required regularly to track levels of fluids and salts in the blood.

Prognosis

Encephalitis symptoms may last several weeks. Most cases of encephalitis are mild, and recovery is usually quick. Mild encephalitis usually leaves no residual neurological problems. Overall, approximately 10 percent of those with encephalitis die from their infections or complications such as secondary infection. Some forms of encephalitis have more severe courses, including herpes encephalitis, in which mortality is 15 to 20 percent with treatment, and 70 to 80 percent without. Antiviral treatment is ineffective for eastern equine encephalitis, and mortality is approximately 30 percent.

Permanent neurological consequences may follow recovery in some cases. Consequences may include personality changes, memory loss, language difficulties, seizures, and partial paralysis.

Prevention

Because encephalitis is caused by infection, it may be prevented by avoiding the infection. Minimizing contact with others who have any of the viral illnesses listed above may reduce one's chances of becoming infected. Most infections are spread by hand-to-hand or hand-to-mouth contact; frequent hand washing may reduce the likelihood of infection if contact cannot be avoided.

Mosquito-borne viruses may be avoided by preventing mosquito bites. Mosquitoes are most active at dawn and dusk and are most common in moist areas with standing water. Covering skin and using mosquito repellents on exposed skin can reduce the chances of being bitten.

Vaccines are available against some viruses, including polio, herpes B, Japanese encephalitis, and equine encephalitis. Rabies vaccine is available for animals; it is also given to people after exposure. Japanese encephalitis vaccine is recommended for those traveling to Asia and staying in affected rural areas during transmission season.

Nutritional Concerns

Adequate nutrition and fluids improve the chances for a full recovery from encephalitis.

Parental Concerns

Parents should carefully monitor their infants and young children for symptoms of fever. Any fever that exceeds 103°F (39.4°C) for more than a few minutes should be promptly treated. Any complaints of a stiff neck, loss of consciousness, unexplained vomiting, or seizure activity should be promptly brought to competent medical attention.

Resources

Books

Halstead, Scott A. "Arbovirus Encephalitis in North America." In Nelson Textbook of Pediatrics, 17th ed. Edited by Richard E. Behrman et al. Philadelphia: Saunders, 2003, pp. 1086–8.

Johnston, Michael V. "Encephalopathies." In Nelson Textbook of Pediatrics, 17th ed. Edited by Richard E. Behrman et al. Philadelphia: Saunders, 2003, pp. 2023–8.

Nath, Avindra, and Joseph R. Berger. "Acute Viral Meningitis and Encephalitis." In Cecil Textbook of Medicine, 22nd ed. Edited by Lee Goldman, et al. Philadelphia: Saunders, 2003, pp. 2232–5.

Tyler, Kenneth L. "Viral Meningitis and Encephalitis." In Harrison's Principles of Internal Medicine, 15th ed. Edited by Eugene Braunwald et al. New York: McGraw-Hill, 2001, pp. 2471–80.

Periodicals

Arciniegas, D. B., and C. A. Anderson. "Viral encephalitis: neuropsychiatric and neurobehavioral aspects." Current Psychiatry Reports 6, no. 5 (2004): 372–9.

Cunha, B. A. "Differential diagnosis of West Nile encephalitis." Current Opinions in Infectious Disease 17, no. 5 (2004): 413–20.

Lyle, P., et al. "Evaluation of encephalitis in the toddler: what part of negative don't you understand?" Current Opinions in Pediatrics 16, no. 5 (2004): 567–70.

Morgan, R. "West Nile viral encephalitis: a case study." Journal of Neuroscience of Nursing 36, no. 4 (2004): 185–8.

Savas, L., et al. "Full recovered meningoencephalomyelitis caused by mumps virus." European Journal of Neurology 11, no. 9 (2004): 639–40.

Organizations

American Academy of Neurology. 1080 Montreal Avenue, St. Paul, MN 55116. Web site: www.aan.com.

American Academy of Pediatrics. 141 Northwest Point Blvd., Elk Grove Village, IL 60007–1098. Web site: www.aap.org/.

American College of Emergency Physicians. PO Box 619911, Dallas, TX 75261-9911. Web site: www.acep.org/.

Web Sites

"Arboviral Encephalitides." Centers for Disease Control and Prevention. Available online at www.cdc.gov/ncidod/dvbid/arbor/ (accessed January 5, 2005).

"Encephalitis." Mayo Clinic. Available online at www.mayoclinic.com/invoke.cfm?id=DS00226 (accessed January 5, 2005).

"Encephalitis." MedlinePlus. Available online at www.nlm.nih.gov/medlineplus/encephalitis.html (accessed January 5, 2005).

"Encephalitis." World Health Organization. Available online at www.who.int/topics/encephalitis/en/ (accessed January 5, 2005).

Encephalitis Information Resource. Available online at www.encephalitis.info/ (accessed January 5, 2005).

"NINDS Encephalitis and Meningitis Information Page." National Institute of Neurological Disorders and Stroke. Available online at www.ninds.nih.gov/health_and_medical/disorders/encmenin_doc.htm (accessed January 5, 2005).

[Article by: L. Fleming Fallon, Jr., MD, DrPH]

An inflammation of the brain. Encephalitis may be caused by a virus or lead poisoning, or it may be a complication of another disease, such as influenza or measles. Encephalitis can cause permanent brain damage or death. It is also possible, however, to recover from it completely.

LearnThatWord.com is a free vocabulary and spelling program where you only pay for results!

Inflammation of the brain. Changes in vessel walls, as well as of nervous tissue, are almost a constant feature of encephalitis.
There are many types of encephalitis, depending on the causative agent and the structures involved. A large percentage of the cases are caused by viruses, some of them, e.g. equine encephalomyelitis, being transmitted from animals to humans. Clinically encephalitis is characterized by initial signs of nervous irritation including muscle tremor, excitement and convulsions, followed by a stage of loss of function characterized by weakness, paralysis, coma and death. The more acute and serious symptoms may include fever, delirium, convulsions, coma, and, in a significant number of patients, death.
Many encephalitides are accompanied by involvement of the spinal cord and are more correctly classified as encephalomyelitides. See also encephalomyelitis.
The etiologically or geographically specific diseases are listed under their specific titles. Human pathogens which sometimes infect animals include Central European, Far Eastern Russian tick-borne encephalitides, Omsk hemorrhagic fever, Kyasanur forest disease. Viruses isolated from asymptomatic cases of encephalomyelitis include Kunjun virus.

• acute disseminated e. — postinfection encephalitis.
• arthropod-borne e. — a group of viral encephalitides of humans in which animals play some epidemiological part. See togaviridae, flaviviridae.
• canine distemper e. — a demyelinating encephalitis, most severe in the cerebellum and optic tracts, is a feature of infection by canine distemper virus.
• demyelinating e. — seen in certain viral infections, e.g. canine distemper, caprine arthritis–encephalitis and visna of sheep.
• equine herpesvirus e. — see equine herpesvirus myeloencephalitis
• granulomatous e. — see granulomatous meningoencephalomyelitis.
• histiocytic e. — see granulomatous meningoencephalomyelitis.
• Israeli turkey e. — see Israeli turkey encephalomyelitis.
• Japanese B e. — believed to be primarily a disease of birds that are the source of infection for animals, including humans, pigs and horses. Transmission is by mosquito. Affected horses show a wide variety of signs including incoordination, excitability and blindness. Most cases recover. Ruminants show little clinical effect. Pigs are a major source of virus and extensive losses occur by way of encephalitis in young pigs and abortion and stillbirth in adult sows.
• Murray Valley e. — there is tentative evidence of clinically inapparent infection of horses in Australia with this flavivirus virus during an epidemic of the disease in humans.
• Nipah virus e. — occurred on the Malaysian peninsula as an epidemic in pig farmers. Pigs are the source of the virus which has antigenic relationship to Hendra virus.
• old dog e. — a chronic, progressive, sclerosing panencephalitis in mature dogs; characterized by motor and mental deterioration, blindness, pacing and circling. Believed to be caused by distemper virus, but there are distinct differences from distemper encephalitis.
• Ontario e. — see hemagglutinating encephalomyelitis virus disease of pigs.
• postinfection e. — an acute disease of the central nervous system seen in patients convalescing from infectious, usually viral, diseases.
• postvaccinal e. — acute encephalitis sometimes occurring after vaccination, mediated by immune mechanisms.
• Powassan e. — a tick-borne flavivirus disease of humans with serological but no clinical evidence of infection in nearby goats.
• Pug e. — see Pug meningoencephalitis.
• Ross River e. — there is tentative evidence of clinically inapparent infection of horses in Australia with the causative mosquito-borne alphavirus virus of this human disease.
• Russian spring–summer e. — a similar and probably identical disease to the flavivirus that causes louping ill of sheep, occurring in central Europe. It is a disease of humans occurring in epidemics related to the prevalence of vector ticks in forests where the disease is most common. Lesions are present in organs other than the brain. The severity varies from mild to fatal.
• St. Louis e. — an arthropod-borne flavivirus infection, first observed in 1932 in Illinois. It is a serious pathogen of humans, but does not cause disease in animals.
• toxoplasma e. — see toxoplasmosis.

An inflammatory condition of the brain.

• Diseases and Infestations - encephalitis: viral or bacterial inflammation of brain, also caused by infection or allergic reaction; sleeping sickness

This article needs additional citations for verification. Please help improve this article by adding citations to reliable sources. Unsourced material may be challenged and removed. (June 2011)

Encephalitis
Classification and external resources
Coronal T2-weighted MR image shows high signal in the temporal lobes including hippocampal formations and parahippogampal gyrae, insulae, and right inferior frontal gyrus. A brain biopsy was performed and the histology was consistent with encephalitis. PCR was repeated on the biopsy specimen and was positive for HSV
ICD-10	A83-A86, B94.1, G05
ICD-9	323
DiseasesDB	22543
eMedicine	emerg/163
MeSH	D004660

Not to be confused with syphilis.

Encephalitis is an acute inflammation of the brain. Encephalitis with meningitis is known as meningoencephalitis. Symptoms include headache, fever, confusion, drowsiness, and fatigue. More advanced and serious symptoms include seizures or convulsions, tremors, hallucinations, and memory problems.

Contents 1 Cause 1.1 Viral 1.2 Bacterial and other 2 Diagnosis 3 Treatment 4 Prevention 5 Encephalitis lethargica 6 Limbic system encephalitis 7 Epidemiology 8 See also 9 References 10 External links

Cause

Viral

Main article: Viral encephalitis

Viral encephalitis can occur either as a direct effect of an acute infection, or as one of the sequelae of a latent infection. The most common causes of acute viral encephalitis are rabies virus, Herpes simplex, poliovirus, measles virus, and JC virus.^[1] Other causes include infection by flaviviruses such as St. Louis encephalitis virus or West Nile virus, or by Togaviridae such as Eastern equine encephalitis virus (EEE virus), Western equine encephalitis virus (WEE virus) or Venezuelan equine encephalitis virus (VEE virus).

Bacterial and other

It can be caused by a bacterial infection, such as bacterial meningitis, spreading directly to the brain (primary encephalitis), or may be a complication of a current infectious disease syphilis (secondary encephalitis). Certain parasitic or protozoal infestations, such as toxoplasmosis, malaria, or primary amoebic meningoencephalitis, can also cause encephalitis in people with compromised immune systems. Lyme disease and/or Bartonella henselae may also cause encephalitis. Cryptococcus neoformans is notorious for causing fungal encephalitis in the immunocompromised. Streptococci, Pneumococci, Staphylococci and certain gram negative bacilli cause ceribritis prior to the formation of a brain abscess.

Another cause is granulomatous amoebic encephalitis.

Diagnosis

Adult patients with encephalitis present with acute onset of fever, headache, confusion, and sometimes seizures. Younger children or infants may present irritability, poor appetite and fever.

Neurological examinations usually reveal a drowsy or confused patient. Stiff neck, due to the irritation of the meninges covering the brain, indicates that the patient has either meningitis or meningoencephalitis. Examination of the cerebrospinal fluid obtained by a lumbar puncture procedure usually reveals increased amounts of protein and white blood cells with normal glucose, though in a significant percentage of patients, the cerebrospinal fluid may be normal. CT scan often is not helpful, as cerebral abscess is uncommon. Cerebral abscess is more common in patients with meningitis than encephalitis. Bleeding is also uncommon except in patients with herpes simplex type 1 encephalitis. Magnetic resonance imaging offers better resolution. In patients with herpes simplex encephalitis, electroencephalograph may show sharp waves in one or both of the temporal lobes. Lumbar puncture procedure is performed only after the possibility of prominent brain swelling is excluded by a CT scan examination. Diagnosis is often made with detection of antibodies in the cerebrospinal fluid against a specific viral agent (such as herpes simplex virus) or by polymerase chain reaction that amplifies the RNA or DNA of the virus responsible (such as varicella zoster virus). Serological tests may show high antibody titre against the causative antigen.

Treatment

Treatment is usually symptomatic. Reliably tested specific antiviral agents are few in number (e.g. acyclovir for herpes simplex virus) and are used with limited success in treatment of viral infection, with the exception of herpes simplex encephalitis. In patients who are very sick, supportive treatment, such as mechanical ventilation, is equally important. Corticosteroids (e.g., methylprednisolone) are used to reduce brain swelling and inflammation. Sedatives may be needed for irritability or restlessness. For Mycoplasma infection, parentral tetracycline is given. Encephalitis due to Toxoplasma is treated by giving a combination of pyrimethamine and sulphadimidine.

Prevention

Post-infectious encephalomyelitis complicating small pox vaccination is totally avoidable now as small pox is now eradicated. Contraindication to Pertussis immunisation should be observed in patients with encephalitis. An immunodeficient patient who have had contact with chicken pox virus should be given prophylaxis with hyperimmune zoster immunoglobulin.

Encephalitis lethargica

Main article: Encephalitis lethargica

Encephalitis lethargica is an atypical form of encephalitis which caused an epidemic from 1918 to 1930. Those who survived sank into a semi-conscious state that lasted for decades until the Parkinson's drug L-DOPA was used to revive those still alive in the late 1960s by Oliver Sacks.

There have been only a small number of isolated cases in the years since, though in recent years a few patients have shown very similar symptoms. The cause is now thought to be either a bacterial agent or an autoimmune response following infection.

Limbic system encephalitis

In a large number of cases, called limbic encephalitis, the pathogens responsible for encephalitis attack primarily the limbic system (a collection of structures at the base of the brain responsible for emotions and many other basic functions).

Epidemiology

On Oct 13, 2011, it was reported that in the Indian state of Uttar Pradesh, 438 people died of encephalitis.^[2]

See also

• Awakenings
• Chronic Fatigue Syndrome aka Myalgic Encephalomyelitis
• Rasmussen's encephalitis

Mystery illness - ovarian teratoma associated encephalitis(audio report)

References

1. ^ Mark Fischione, M.D., AT Still University SOMA, Pathology Lecture. October 2011
2. ^ IBN, CNN. "Encephalitis kills 6 more, Death Toll 438". CNN-IBN. CNN-IBN. http://www.youtube.com/watch?v=oMtrb9ebi60&feature=related. Retrieved 13 October 2011. 

• Shaw PJ, Walls TJ, Newman PK, Cleland PG, Cartlidge NE (February 1991). "Hashimoto's encephalopathy: a steroid-responsive disorder associated with high anti-thyroid antibody titers—report of 5 cases". Neurology 41 (2 (Pt 1)): 228–33. PMID 1992366. 

External links

• WHO: Viral Encephalitis
• Meningitis and Encephalitis Information Page at NINDS
• MR & CT scan diagnosis of HSV encephalitis Medical Image Database

v d e Inflammation Acute Plasma derived mediators Bradykinin · complement (C3, C5a, MAC) · coagulation (Factor XII, Plasmin, Thrombin) Cell derived mediators preformed: Lysosome granules · vasoactive amines (Histamine, Serotonin) synthesized on demand: cytokines (IFN-γ, IL-8, TNF-α, IL-1) · eicosanoids (Leukotriene B4, Prostaglandins) · Nitric oxide · Kinins Chronic Macrophage · Epithelioid cell · Giant cell · Granuloma Processes Traditional: Rubor · Calor · Tumor · Dolor (pain) · Functio laesa Modern: Acute-phase reaction/Fever · Vasodilation · Increased vascular permeability · Exudate · Leukocyte extravasation · Chemotaxis Specific locations Nervous CNS (Encephalitis, Myelitis) · Meningitis (Arachnoiditis) · PNS (Neuritis) · eye (Dacryoadenitis, Scleritis, Keratitis, Choroiditis, Retinitis, Chorioretinitis, Blepharitis, Conjunctivitis, Iritis, Uveitis) · ear (Otitis, Labyrinthitis, Mastoiditis) Cardiovascular Carditis (Endocarditis, Myocarditis, Pericarditis) · Vasculitis (Arteritis, Phlebitis, Capillaritis) Respiratory upper (Sinusitis, Rhinitis, Pharyngitis, Laryngitis) · lower (Tracheitis, Bronchitis, Bronchiolitis, Pneumonitis, Pleuritis) · Mediastinitis Digestive mouth (Stomatitis, Gingivitis, Gingivostomatitis, Glossitis, Tonsillitis, Sialadenitis/Parotitis, Cheilitis, Pulpitis, Gnathitis) · tract (Esophagitis, Gastritis, Gastroenteritis, Enteritis, Colitis, Enterocolitis, Duodenitis, Ileitis, Caecitis, Appendicitis, Proctitis) · accessory (Hepatitis, Cholangitis, Cholecystitis, Pancreatitis) · Peritonitis Integumentary Dermatitis (Folliculitis) · Cellulitis · Hidradenitis Musculoskeletal Arthritis · Dermatomyositis · soft tissue (Myositis, Synovitis/Tenosynovitis, Bursitis, Enthesitis, Fasciitis, Capsulitis, Epicondylitis, Tendinitis, Panniculitis) Osteochondritis: Osteitis (Spondylitis, Periostitis) · Chondritis Urinary Nephritis (Glomerulonephritis, Pyelonephritis) · Ureteritis · Cystitis · Urethritis Reproductive female: Oophoritis · Salpingitis · Endometritis · Parametritis · Cervicitis · Vaginitis · Vulvitis · Mastitis male: Orchitis · Epididymitis · Prostatitis · Balanitis · Balanoposthitis pregnancy/newborn: Chorioamnionitis · Omphalitis Endocrine Insulitis · Hypophysitis · Thyroiditis · Parathyroiditis · Adrenalitis Lymphatic Lymphangitis · Lymphadenitis

v d e Pathology of the nervous system, primarily CNS (G04–G47, 323–349) Inflammation Brain Encephalitis (Viral encephalitis, Herpesviral encephalitis) · Cavernous sinus thrombosis · Brain abscess (Amoebic) Spinal cord Myelitis: Poliomyelitis · Demyelinating disease (Transverse myelitis) · Tropical spastic paraparesis · Epidural abscess Both/either Encephalomyelitis (Acute disseminated) Meningoencephalitis Brain/ encephalopathy Degenerative Extrapyramidal and movement disorders Basal ganglia disease: Parkinsonism (PD, Postencephalitic, NMS) · PKAN · Tauopathy (PSP) · Striatonigral degeneration · Hemiballismus · HD · OA Dyskinesia: Dystonia (Status dystonicus, Spasmodic torticollis, Meige's, Blepharospasm) · Chorea (Choreoathetosis) · Myoclonus (Myoclonic epilepsy) · Akathesia Tremor (Essential tremor, Intention tremor) · Restless legs · Stiff person Dementia Tauopathy: Alzheimer's (Early-onset) · Frontotemporal dementia/Frontotemporal lobar degeneration (Pick's, Dementia with Lewy bodies) Multi-infarct dementia Mitochondrial disease Leigh's Demyelinating autoimmune (Multiple sclerosis, Neuromyelitis optica, Schilder's disease) · hereditary (Adrenoleukodystrophy, Alexander, Canavan, Krabbe, ML, PMD, VWM, MFC, CAMFAK syndrome) · Central pontine myelinolysis · Marchiafava-Bignami disease · Alpers' disease Episodic/ paroxysmal Seizure/epilepsy Focal · Generalised · Status epilepticus · Myoclonic epilepsy Headache Migraine (Familial hemiplegic) · Cluster · Tension Cerebrovascular TIA (Amaurosis fugax, Transient global amnesia) Stroke (MCA, ACA, PCA, Foville's, Millard-Gubler, Lateral medullary, Weber's, Lacunar stroke) Sleep disorders Insomnia · Hypersomnia · Sleep apnea (Obstructive, Ondine's curse) · Narcolepsy · Cataplexy · Kleine-Levin · Circadian rhythm sleep disorder (Advanced sleep phase disorder, Delayed sleep phase disorder, Non-24-hour sleep-wake disorder, Jet lag) CSF Intracranial hypertension (Hydrocephalus/NPH, Idiopathic intracranial hypertension) · Cerebral edema · Intracranial hypotension Other Brain herniation · Reye's · Hepatic encephalopathy · Toxic encephalopathy Spinal cord/ myelopathy Syringomyelia · Syringobulbia · Morvan's syndrome · Vascular myelopathy (Foix-Alajouanine syndrome) · Spinal cord compression Both/either Degenerative SA Friedreich's ataxia · Ataxia telangiectasia MND UMN only: PLS · PP · HSP LMN only: PMA · PBP (Fazio-Londe, Infantile progressive bulbar palsy) · Spinal muscular atrophies (SMA, SMARD1, SBMA, SMAX2, SMA-PCH) both: ALS M: CNS anat(n/s/m/p/4/e/b/d/c/a/f/l/g)/phys/devp noco(m/d/e/h/v/s)/cong/tumr, sysi/epon, injr proc, drug(N1A/2AB/C/3/4/7A/B/C/D)

This entry is from Wikipedia, the leading user-contributed encyclopedia. It may not have been reviewed by professional editors (see full disclaimer)

Dansk (Danish)
n. - hjernebetændelse

Nederlands (Dutch)
hersenontsteking, encefalitis

Français (French)
n. - encéphalite

Deutsch (German)
n. - Gehirnentzündung, Enzephalitis

Ελληνική (Greek)
n. - (παθολ.) εγκεφαλίτιδα

Italiano (Italian)
encefalite

Português (Portuguese)
n. - encefalite (f) (Med.)

Русский (Russian)
энцефалит

Español (Spanish)
n. - encefalitis, cefalitis

Svenska (Swedish)
n. - encefalit, hjärninflammation

中文（简体）(Chinese (Simplified))
脑炎

中文（繁體）(Chinese (Traditional))
n. - 腦炎

한국어 (Korean)
n. - 뇌염

日本語 (Japanese)
n. - 脳炎

العربيه (Arabic)
‏(الاسم) التهاب, الدماغ‏

עברית (Hebrew)
n. - ‮דלקת המוח וחוט-השדרה‬

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