Encephalopathyandencephalitisare acute brain diseases. Both are rare and potentially deadlier forms of disease conditions that may lead to permanent brain damage or death. In both cases, the patient shows a similaraltered mental status. It is very easy to confuseencephalopathywithencephalitis. Although the words sound similar, they are under different conditions.
The following differences can be seen in causes, signs, symptoms, and laboratory tests of encephalopathy and encephalitis:
- The brain itself is swollen or inflamed in encephalitis, whereas in encephalopathy, the altered mental state occurs due to several types of health problems. However, encephalitis can cause encephalopathy.
- Encephalopathy has many causes, but mainly it is due to atraumaor an injury, may have ill-defined pathology and can be interchangeably used with the term encephalitis. However, encephalitis always has very well-defined infective causes such asvirusesor bacteria (rarely due to the abnormal immune response of the body).
- In encephalitis, the patient commonly gets afever,headache,flu-like symptoms,vomiting, andstiff neckand affects the specific region of the body (focal neurological signs) such as one-sidedparalysis, which is uncommon in encephalopathy.
- Depressedmental status may show a steady deterioration in encephalopathy, but it may fluctuate in a patient with encephalitis.
- Generalizedtypes of seizuresare common in encephalopathy that affects the whole brain, whereas generalized partial (focal)seizuresare common in encephalitis that may affect a limited area of the brain.
- In the blood test, increased white blood cell count (leukocytosis) and abnormal spinal fluid (pleocytosis) tests are very commonly seen in encephalitis due to infections that are uncommon in encephalopathy.
- Encephalitis often shows symptoms of infection that can be detected in laboratory tests, whereas encephalopathy is a gross brain dysfunction that could be due to many reasons such as drug effects, toxins, or lack of oxygen, and can even clinically be detected.
- Magnetic resonance imaging(MRI) often shows normal reports of encephalopathy. However, in encephalitis, MRI reports may show abnormal focal points due to infection.
Early diagnosis and treatment are important because it is very difficult to predict thesymptoms of encephalitisin each patient. A serious condition affecting the brain requires immediate treatment to reduce the risk of lasting complications or death.
What are symptoms of encephalopathy?
Encephalopathy is a clinical syndrome (a group of disorders) that damages the brain resulting in brain dysfunction.
The symptoms of encephalopathy are as follows:
- Confusion
- Disorientation
- Trouble thinking clearly or focusing
- Behavioral changes
- Memory loss
- Personality changes
- Trouble speaking
- Rapid uncontrolled eye movements
- Sleepiness
- Seizures
- Trouble swallowing
- Muscleweakness,tremors, or twitching
- Reduced orloss of consciousness
It may be caused by metabolic abnormalities such asdiabetes,liverfailure,kidney failure, prolonged exposure to toxins (solvents, lead-containing paints, industrial chemicals, and certain metals),alcohol abuse,drug abuse,thiaminedeficiency,radiation, brain tumor, or increased pressure in the head, poornutrition, trauma, and lack of oxygen or blood flow to the brain.
What are symptoms of encephalitis?
脑炎是一种特定类型的脑病that is most infectious in origin. It occurs due to infective causes such as viruses (herpessimplex virus [HSE],chickenpoxvirus,varicellavirus, Germanmeaslesvirus,Epstein-Barr virus,human immunodeficiency virus[HIV],cytomegalovirus[CMV], and enteroviruses], bacteria, fungus, and rarely due to abnormal immune system response.
The patient may experience the following:
- A highfever
- Headache
- Altered mental status
- Unusual behavior
- Confusion
- Personality changes
- Emotional lability
- Stiff neck
- Nauseaandvomiting
- Sensitivity to light
- Convulsions
- Drowsiness
- Bulging of the fontanels (a soft part of the top of the head) (inbabies)
SLIDESHOW
Brain Food Pictures: What to Eat to Boost FocusSee SlideshowHow are encephalitis and encephalopathy detected?
Your doctor/neurologistmay examine for concentration, memory, and other mental tasks.
To differentiate the type of encephalopathy or encephalitis, they may order:
- Blood and urine tests.
- Spinal fluid sample (taken by inserting a needle into your spine) test.
- Computed tomography (CT) scan.
- Magnetic resonance imaging (MRI).
- Electroencephalography (EEG).
How are encephalopathy and encephalitis treated?
Depending on the specific cause of encephalopathy and encephalitis, your neurologist may decide on the treatment plan. Early detection and treatment of the underlying cause are essential to reverse or limit the effects of encephalopathy or encephalitis.
If an infection is detected in your blood and spinal fluid tests, your doctor may recommend:
- Antivirals such asZovirax(acyclovir) for a viral infection.
- Antibiotic treatment for a bacterial infection.
- Antifungal treatments for fungal encephalitis.
Moreover, immunotherapy and other supportive care treatments such as lots of fluid intakes, dietary changes, nutritionalsupplements, and bed rest are important for faster recovery.
治疗脑病异好的n the type and severity of the disease. Your doctor may provide specific instructions for proper care and treatment.
Depending upon the symptoms, your neurologist may also suggest the following treatment options:
- Medications such ascarbamazepineand Eptoin (phenytoin) to stop seizures.
- Sedativesto calmagitation.
- Steroids such asprednisolonereduce inflammation.
- Painrelievers such asibuprofen.
- Anti-inflammatory medication to reduce swelling.
- Water pills (diuretics) such asLasix(furosemide) reduce the pressure in the head.
- Oxygen treatment to easebreathing.
- Speech therapy, occupational therapy, and physiotherapy to manage longer-lasting symptoms.
- Dialysis(blood purification using a machine) or an organ transplant if liver or kidney problems are the cause (in severe cases).
- Occasionally head surgery to reduce the pressure inside the skull.
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Medscape https://emedicine.medscape.com/article/186101-overview https://emedicine.medscape.com/article/791896-overview
国家卫生研究院:神经diso研究所rders and stroke: https://www.ninds.nih.gov/Disorders/All-Disorders/Encephalopathy-Information-Page
NHS: https://www.nhs.uk/conditions/encephalitis/
Quist-Paulsen E, Kran AB, Lindland ES, et al. To what extent can clinical characteristics be used to distinguish encephalitis from encephalopathy of other causes? Results from a prospective observational study. BMC Infect Dis. 2019;19(1):80. Published 2019 Jan 22. doi:10.1186/s12879-018-3570-2.
Brain and spine organization https://www.brainandspine.org.uk/our-publications/our-fact-sheets/encephalitis/
Brain foundation: https://brainfoundation.org.au/disorders/encephalitis/
National organization of rare disease: https://rarediseases.org/rare-diseases/rasmussen-encephalitis/
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