*

http://www.youtube.com/watch?v=rTxKmledzVw

Is an inflammation of cerebral tissue typically accompanied by meningeal inflammation, caused by an infection or other source.
http://www.youtube.com/watch?v=KXm4P_9REKY

* It can present as acute viral encephalitis, most

frequently caused by herpes virus and most commonly occurring in children. * Cytomegalovirus (CMV) and toxoplasma are common causes in patients with acquired immunodeficiency syndrome. * It may also present as post-infectious encephalitis, which follows a viral or bacterial infection, usually of the respiratory or GI tract. * It may also present as an anthropod-borne infection such as West Nile Virus.

* The disease, which is commonly fatal, causes

lymphocytic infiltration of the brain, which leads to cerebral edema, basal ganglia degeneration, and diffuse nerve cell destruction.

* Complications include motor and sensory

deficits, amnesia syndrome, syndrome of inappropriate antidiuretic hormone (SIADH), coma, and death.

* Lumbar puncture evaluates cerebrospinal fluid (CSF)

for increased cell count; polymerase chain reaction analysis of CSF for viral antibodies. * Electroencephalogram may reveal abnormalities. * Gadolinium-enhanced magnetic resonance imaging can detect different patterns of inflammation to differentiate type of encephalitis. * Blood cultures rarely identify causative organism, but brain-tissue biopsy may indicate presence of microorganism. * West Nile virus serologic testing on blood or CSF.

*
* Antiviral agent acyclovir given I.V. for 10 days to 3 weeks for
herpes simplex virus.

* Blood cultures and foscarnet I.V. for CMV encephalitis. * Anticonvulsants to treat seizures * Corticosteroids to reduce cerebral edema * Sedatives and analgesics as supportive therapy.

* Monitoring pupils and vital signs frequently for increased

intracranial pressure (ICP; irregular pupils, widening pulse pressure, tachycardia, irregular breathing hyperthermia).
adverse reactions.

* Monitor the patients response to medications and observe for

* Monitor neurologic status closely. Watch for

subtle changes, such as behavior or personality changes, weakness, or cranial nerve involvement. adequate hydration.

* Monitor fluid intake and output to ensure * Maintain quiet environment and provide care
gently, to avoid excessive stimulation and agitation, which may cause increase ICP

* Maintain seizure precautions; pad side rails of bed and have

airway and suction equipment available at bedside.

* Maintain standard precautions and additional isolation

according to hospital policy to prevent transmission.

* Administer antipyretics and other cooling measures as

indicated.

* Provide fluid replacement through I.V. lines as

needed.

* Reorient patient frequently. * Provide supportive care if coma develops; may

last several weeks.

* Encourage significant others to interact with

patient with even while in coma and to participate in care to promote rehabilitation.