A mild form of encephalitis. Diseases with which differential diagnosis is carried out

Encephalitis: causes, signs, treatment, prevention - tick-borne, viral

Scientists of antiquity must have encountered such a severe pathology as encephalitis, but since medical knowledge was only in its infancy, precise methods there was no diagnosis, and there were no ideas about microorganisms at all, then the inflammatory processes of the brain, often accompanied by an increase in body temperature, were simply attributed to fevers, a change in consciousness in which no one is surprised to this day.

With the development of medical science, enough evidence has been accumulated that inflammation is possible not only in visible to the eye tissues, but also in internal organs, and the brain is no exception. Neurological symptoms on the background bright signs intoxication and fever makes it possible to suspect encephalitis already when examining the patient, although the exact cause of the disease can not always be established.

The causes and forms of brain inflammation are quite diverse, but a special place is occupied by tick-borne encephalitis, which is a dangerous independent disease, often leading to a tragic outcome. We will give tick-borne encephalitis Special attention a little lower.

Despite all the variety of causes and types of encephalitis, its manifestations are rather stereotypical in severe course disease, but if inflammation nervous tissue accompanies other ailments, it is not so easy to recognize encephalitis as such. It happens, for example, that a change in consciousness, headache, vomiting and other signs of trouble in the brain are attributed to intoxication, fever, dehydration. By and large, if encephalitis is secondary to other serious diseases and develops as their complication, then the patient by that time already receives enough wide range drugs, and the hospital has the ability to quickly conduct appropriate research. This cannot be said about a special form of brain damage - tick-borne encephalitis. A tick bite does not make everyone want to examine it for infection, and then the disease can be taken by surprise.

Inflammation of the brain tissue is a difficult process, dooming death at worst, and drastic changes in activity at best. nervous system and legitimate disability. A relatively favorable outcome with encephalitis, although it happens, is quite rare, so any suspicious symptoms regarding brain damage should not go unnoticed by the doctor.

Types and causes of inflammation in the brain

Depending on the cause, there are:

1. Encephalitis infectious origin(viral, bacterial, fungal).
2. Toxic encephalitis in case of poisoning with various poisons.
3. Autoimmune encephalitis.
4. Post-vaccination.

In most cases, encephalitis is caused by viruses or bacteria that enter the brain. with blood or lymph flow. Some microorganisms immediately choose the nervous tissue as the most favorable habitat for themselves (neurotropic viruses), while others get there during a severe course of an infectious disease of another localization.

With influenza, measles, HIV infection, rubella or chickenpox, brain damage is secondary and is characteristic of severe forms of these diseases, while rabies, herpes, tick-borne encephalitis Initially, they choose the nervous tissue for their life activity, without affecting other organs. Most neurotropic viruses tend to cause epidemic outbreaks of the disease with a clear seasonality and geographical features. In hot countries with an abundance of blood-sucking insects, in the taiga, where tick activity is very high, outbreaks of encephalitis are recorded quite often, so alertness among medical workers these regions is extremely high during periods maximum risk infection, and the population is informed about possible consequences disease and actively vaccinated.

map of the predominant distribution of viral tick-borne encephalitis

Bacterial encephalitis is somewhat less common, can occur with purulent inflammation and involvement in the process of the pia mater (meningoencephalitis).

The main route of infection to the brain is considered to be hematogenous (with blood flow), when, after a mosquito or tick bite, viruses enter the bloodstream and are sent to the nervous tissue. Also not excluded contact-household way transmission, airborne (herpes), alimentary when an infection enters through the gastrointestinal tract (enteroviruses).

However, microbes are not always the cause of brain damage. In some cases, encephalitis develops against the background of the toxic effects of various poisons ( heavy metals, carbon monoxide), autoimmune process, allergic reaction.

Frequent vaccinations, non-compliance with the terms indicated in the vaccination schedule, can also cause inflammation of the brain substance. The most dangerous in this respect are DTP vaccines, against smallpox and rabies, which may contain live microorganisms and, under certain conditions, cause complications in the form of brain lesions.

Often it is not possible to establish the exact cause of the disease, so the localization, prevalence and course of encephalitis are also taken into account. If the inflammatory process began initially in the brain, and the changes are limited to the nervous tissue, then encephalitis will be called primary. In this case, most often the culprit will be a neurotropic virus. O secondary encephalitis they say when there are prerequisites for the subsequent involvement of the brain in the pathological process in other diseases: severe measles or influenza, immunity disorders, malignant tumors, an autoimmune process, HIV infection, etc. The selection of these forms is also reflected in the subsequent treatment tactics patient.

The inflammatory process may affect predominantly the white matter of the brain ( leukoencephalitis), or gray (bark), then they talk about polioencephalitis. Inflammation of both white and gray matter along with conductive neural pathways represents the most severe form brain damage - panencephalitis. In some cases, not only the substance of the brain is involved, but also its membranes, in particular, the vascular one, this condition is called meningoencephalitis.

What happens with encephalitis?

Changes in the nervous tissue in encephalitis are rather stereotypical, and only in some cases can signs of a specific disease be detected (rabies, for example). The significance for the body and the consequences of any inflammatory changes in the brain are always serious, so you should not once again remind them of their danger.

Edema, hemorrhages, accumulations of inflammatory blood cells (leukocytes), destruction of the membranes and the processes of neurons themselves lead to irreversible changes, and the low ability of the nervous tissue to regenerate does not give patients a chance for a favorable outcome and restoration of lost functions.

The structures of the subcortical nuclei, white matter, medulla oblongata and stem are often damaged, therefore, the manifestations are not limited to cerebral symptoms, and indispensable companions of such encephalitis will be paralysis, respiratory failure, functions of the cardiovascular system, etc.

Beyond the damage nerve cells, the patient's condition is aggravated by increasing cerebral edema, which certainly accompanies any inflammation, regardless of its nature and location. Enlarged, edematous brain does not fit well in cranium, rises, and the patient's condition progressively worsens. Along with damage to vital nerve centers, swelling can be fatal in encephalitis.

At bacterial infection inflammation often becomes purulent, spreading to the pia mater. In such cases, in addition to foci of purulent fusion in the brain tissue, a kind of "cap" or, as they also call it, a "purulent cap" is formed, enveloping the already suffering brain. This condition is very, very dangerous, and delaying medical care can cost lives.

Manifestations of encephalitis

Signs of encephalitis are determined by the cause, localization of the focus of inflammation, the course of the disease, but in most cases, against the background of focal neurological changes, they are expressed and general symptoms brain damage. These include:

• , often intense, all over the head, without a clear localization.
• Nausea and vomiting that does not bring relief, which makes it possible to exclude pathology gastrointestinal tract in favor of the brain.
• Impaired consciousness - from mild drowsiness to coma with loss of response to external stimuli.
• Fever, at which the temperature, as a rule, exceeds the threshold of 38 degrees and is difficult to reduce, since it is associated with damage to the corresponding structures of the brain.

Focal symptoms of encephalitis are predetermined by the part of the brain in which pathological changes are most pronounced. So, patients may lose the ability to coordinate movements with the involvement of the cerebellum, vision is impaired with damage to the occipital lobe, pronounced changes intellectual sphere and behavioral reactions accompany inflammation in the frontal lobes.

Encephalitis can occur in the form of the so-called abortive form, when the symptoms of brain damage are limited to moderate pain in the head and stiff neck. In the presence of such symptoms, fever, signs of a respiratory or gastrointestinal infection, it is necessary to examine the cerebrospinal fluid to rule out brain pathology.

Tick-borne encephalitis

Having set out to learn a little more about the inflammatory processes in the brain, it is easy to see that most of Information on this issue is devoted to tick-borne encephalitis. This is not surprising, because tick-borne encephalitis, being an independent disease, affects absolutely healthy people of any age and gender, and the seasonality and mass nature of infection with the infectious agent make it necessary to navigate the essence of the disease not only for health workers, but also for people at risk.

The danger of tick-borne encephalitis lies in the fact that in almost all cases it leaves behind persistent neurological disorders that not only limit the subsequent life of the sick person, but also capable of chaining him to bed forever. In children, the disease is more severe than in adults, and residual effects and dangerous consequences can radically change lives little man far from being the best.

A bit of history

The first published descriptions of a seasonal disease that occurs with damage to the nervous system appeared at the end of the 19th century. In the first third of the last century, large-scale scientific research was already carried out, which bore fruit: the pathogen (virus) was isolated, the carrier (tick) was identified, and clinical picture diseases, approaches to treatment and, what is very important, preventive measures have been developed.

However, the study of tick-borne encephalitis, like any other infectious disease, did not pass without tragic episodes, when the selfless work of scientists led to their death.

The development of Siberia and Far East in the 30s of the last century, the development of industry and the strengthening of the border required an influx of qualified personnel into these regions, and along with the construction of numerous correctional institutions, led to the resettlement huge amount people for whom the climate and natural features of the area turned out to be alien. It was then that the attention of A. G. Panov was attracted by mass outbreaks of a seasonal disease with damage to the central nervous system. Already in 1937, an expedition was organized under the leadership of Professor L. A. Zilber, whose members came to grips with the study of the nature of encephalitis.

dog and taiga ticks - both can be carriers of encephalitis

Thanks to the efforts of virologists, infectious disease specialists, with the active help of Khabarovsk neurologists, who knew firsthand about dangerous disease, the causative agent of the infection was established, which turned out to be a virus, as well as the most likely carrier - the ixodid tick, whose favorite habitat is taiga regions.

The disease spared no one. Most of those who were bitten by the tick developed encephalitis, and the risk of death remained and remains quite high. Among those affected by insidious infection there are also many scientists, employees of virological laboratories, doctors who conducted research in the field. So, one of the discoverers of the viral nature of tick-borne encephalitis, MP Chumakov, contracted the infection during the autopsy of a deceased patient. acute form The disease changed to chronic and pursued the scientist until the end of his life. Despite the hearing impairment and movement disorders, Academician Chumakov continued to work actively long years, and bequeathed his body to study the chronic form of encephalitis, which had been occurring for decades. One of the entomologists, B. I. Pomerantsev, who was searching for the carrier of the infection, died after a tick bite from a severe form of encephalitis.

Not without politics. Shortly after the start of the expedition, in the midst of research work, its leader, Professor Zilber, and two other employees were arrested, who were suspected of spreading Japanese encephalitis in the region, but the accusation was false, and 1937 was marked by the discovery of the tick-borne encephalitis virus thanks to selfless Russian scientists.

Where does the infection come from?

As noted above, tick-borne encephalitis is common in the forest and forest-steppe zones of Siberia, the Urals, the Far East, and is found in many countries of the central and western parts of the Eurasian continent (France, Germany, Poland, Belarus, the Baltic region). Cases of tick-borne encephalitis are also recorded in Mongolia and the wooded part of China. Every year, in Russia alone, more than half a million people seek medical help after a tick bite, including children. The infection is especially severe in residents of the Far East, where the frequency severe complications and deaths are especially high.

the prevalence of encephalitis in the regions of Russia (incidence per 100,000 people)

In nature, the tick-borne encephalitis virus is found in animals and birds - rodents, wolves, elk, cattle, which serve as a source of food for ticks, infecting them at the same time. A person among them happens to be by chance, but for a tick it does not matter whose blood it will feed on and to whom it will transmit the virus.

There is a pronounced seasonality of the disease, the peak of which falls on the spring-summer period. The culprits of this are also ixodid ticks, which, after a long winter hibernation, crawl out to the surface and begin to hunt. Ticks hunt in the literal sense, that is, they wait for the victim and attack.

Hungry ticks prefer to wait for prey in shady bushes or grass, crawling out of the forest floor and spreading up to a height of one and a half meters. This happens when you visit the forest, but you need to remember that the tick itself can “come” into the house: with flowers, branches, clothes, pets, so even a family member who avoids forest walks can suffer.

Due to the ability to feel the change in concentration carbon dioxide in the environment and thermal radiation, the tick accurately determines the approach of a food source and attacks. Lacking the ability to jump or fly, it clings to or falls on its prey. On the human body, the tick always crawls up, reaching the thin and delicate skin of the neck, abdomen, chest, axillary zones. Since insect saliva contains substances with anticoagulant and anesthetic properties, then the bite may not be immediately noticeable, so brushing it off like a mosquito or midge will not work. Moreover, if females stick for a long period of time, then males do it quickly, so the very fact of a tick bite can go unnoticed, then the cause of the malaise and the subsequent development of the disease can not be established immediately. The female can remain on the human body for many days, and only after being saturated with blood and having increased in weight by several tens, or even a hundred times, does she leave the victim.

The risk group for viral tick-borne encephalitis includes foresters and other workers whose activities are associated with visiting forests, geologists, road builders, tourists, avid fans of picking mushrooms and berries, or just walking and having picnics in nature. In areas endemic for encephalitis, this may not be safe.

You can get infected with tick-borne encephalitis not only in the forest, but also in city parks and squares, in gardens and summer cottages. It is worth remembering this when intending to take a walk in the shade of trees, even within the city limits.

In addition to the transmissible route of transmission of infection (through an insect bite), cases of infection have been described when eating raw goat or cow's milk. This happens in children who are given raw milk from private farms. Boiling destroys the encephalitis virus, so do not neglect such a simple procedure, especially when it comes to the smallest.

Features of the course of tick-borne encephalitis

The tick-borne encephalitis virus, having entered the bloodstream, is sent to the nervous tissue, affecting the cerebral cortex, white matter, subcortical nuclei, cranial nerves, spinal roots, causing paresis and paralysis, changes in sensitivity. Involvement of various brain structures can cause seizures, impaired consciousness up to coma, cerebral edema. The older the patient, the higher the risk of complications and severe course of the disease, and after 60 years the probability of death is especially high.

Like any other infection, tick-borne encephalitis occurs with a latent period, during which there may be no signs of the disease at all.

Average the incubation period lasts 1-2 weeks, maximum - 30 days, when the infectious agent multiplies intensively already in the human body. By the end of the latent course, weakness, weakness, body aches, fever, that is, symptoms common to many infectious diseases, therefore it is so important to establish the fact of a tick bite, because it is not so easy to suspect encephalitis in such cases.

Depending on the predominance of one or another symptom of the disease, tick current forms encephalitis:

1. Feverish.
2. Meningeal.
3. With focal lesions of the nervous tissue.
4. Chronic variants of the course.

The first three forms are classified as acute encephalitis, and the febrile and meningeal varieties account for about 90% of all cases of the disease. Chronic tick-borne encephalitis is diagnosed much less often, which can last for years, continuously progressing and leading to persistent neurological disorders.

Without focusing on a detailed description of the various symptoms of damage to the nervous system, it is worth pointing out development in patients of three main syndromes:

1. General infectious nature.
2. Meningeal.
3. Syndrome of focal pathology of the nervous system.

manifestations of encephalitis

Signs of a general infectious nature are associated with increased reproduction of the virus and its spread not only to the nervous tissue, but also to other parenchymal organs, as well as the impact on the walls of blood vessels. Patients develop a severe fever with a rise in temperature to 39-40 degrees, chills, weakness, muscle and bone pain, and dyspeptic disorders are possible.

meningeal syndrome associated with damage to the pia mater and increased intracranial pressure. It includes a severe headache, nausea, repeated vomiting that does not bring relief, impaired consciousness, photophobia, convulsions, psychomotor agitation.

Syndrome of focal neurological disorders associated with damage to specific parts of the nervous system and is manifested by paralysis, paresis, impaired sensitivity and function of the cardiovascular, respiratory system, convulsive syndrome.

Feverish form disease is characterized favorable prognosis and a quick recovery. This is the most soft form course of tick-borne encephalitis, occurring with little or no damage to the nervous tissue by the virus. Symptoms are fever, common features infectious process(nausea, weakness, headache). Fever and flu-like changes last for about three to five days, after which recovery begins.

meningeal variant The course of encephalitis is considered the most frequent, and the manifestations are headache, soreness in the eyes, nausea and vomiting. In addition to the characteristic symptoms, changes in the cerebrospinal fluid can also be detected. Signs of defeat meninges in the form of stiff neck muscles and other meningeal symptoms, a health worker of any specialty can easily determine, therefore, the diagnosis of this form of the disease after a tick bite does not cause great difficulties. The fever lasts about one to two weeks, and then recovery occurs. The meningeal form is considered favorable, although the consequences in the form of headaches can accompany the patient for quite some time.

A form of tick-borne encephalitis with focal neurological disorders the rarest and, at the same time, the most severe in terms of course and consequences. Mortality with it reaches 40% with the Far Eastern type of infection. With simultaneous damage to the meninges and brain matter (meningoencephalitis), the course of the disease is very severe: fever, nausea and vomiting, headache, convulsions up to epistatus, impaired consciousness in the form of delirium, hallucinations, coma. The recovery process is delayed up to 2 years or more, and the consequences in the form of paralysis and muscle atrophy persist for life.

In addition to the cerebral hemispheres, damage to the brain stem, spinal roots and peripheral nerves is possible. These cases are accompanied by persistent paralysis, a strong pain syndrome and inevitably lead to serious disorders that turn earlier healthy person in a disabled person, bedridden, unable to move or even speak. Such patients remain profoundly disabled, who need constant care and supervision, since even eating becomes a problem.

In children, the disease is severe and more often recorded in boys of primary school age. The forms of the course of infection are similar to those described for adults. Symptoms of brain damage develop rapidly and leave consequences in the form of paralysis, etc. In children, more often than in adults, complications are observed in the form convulsive syndrome and hyperkinesis - involuntary excessive movements of the limbs, head, torso, sometimes persisting for life. Since a child often does not know about the danger of tick bites, and even more so, does not carefully examine the skin after walking in a forest or park, the task of preventing and timely detection of blood-sucking insects lies with the parents.

Video: consequences of tick-borne encephalitis

Identification and treatment of tick-borne encephalitis

Diagnosis of encephalitis is based on a characteristic clinical picture, data on visiting forests, and the presence of a tick bite. Used to confirm the diagnosis laboratory methods , allowing to detect specific antibodies (proteins) produced in the patient's body in response to the introduction of the virus. When contacting a doctor, the first thing the patient will be offered is to donate blood, in which elevated leukocytes, accelerated ESR can be detected, but these changes are nonspecific and accompany many other diseases, so it is so important to conduct serological studies to search for antibodies.

Equally important is analysisliquor, in which the content of lymphocytes and protein increases, and its outflow under pressure indicates intracranial hypertension. It should be noted that it is not always possible to examine the cerebrospinal fluid. For example, in coma and dysfunction medulla oblongata this manipulation is contraindicated, and doctors are forced to wait for the stabilization of the patient's condition. At the same time, with a relatively mild febrile form of the disease, there are no changes in the cerebrospinal fluid, and the diagnosis is based on the search for antiviral antibodies.

Can bring invaluable benefits tick analysis for the presence of tick-borne encephalitis virus in it, therefore it is so important not only to remove it when it is found on the body, but also to save it and transfer it to the appropriate laboratory. If the concerns about tick infection are confirmed, then it is possible to prevent the disease in advance and start treatment as early as possible.

Treatment of tick-borne encephalitis requires mandatory hospitalization in the department intensive care. Patients are shown strict bed rest with minimizing all kinds of irritants. Balanced diet plays an important role, especially since the infection is often accompanied by dysfunction of the digestive system.

Therapy prescribed includes:

Video: what to do after suffering encephalitis?

Prevention of tick-borne encephalitis

The rule "disease is easier to prevent than to cure" works very well in relation to tick-borne infections, and therefore preventive measures are of paramount importance in the foci of the spread of the disease.

Prevention of tick-borne encephalitis includes non-specific measures that are desirable to observe and know for those who live in dangerous areas and visit tick habitats. Specific prevention consists in the use of vaccines according to the developed schemes.

When visiting forests and other habitats of ticks, you need to follow simple rules:

1. Clothing should be as closed as possible, overalls are preferred, a scarf or cap is required, and it is better to protect the neck and head with a hood. Collar, sleeve cuffs, socks should fit snugly against the surface of the skin. If possible, you should wear light-colored and plain clothes so that in the event of a tick attack, it is easier to notice. At home, clothes should be shaken out and it is advisable to leave them away from living quarters;
2. Good to see as often as possible skin not only to yourself, but also to ask others, because the scalp, back, back of the neck is quite problematic to carefully examine even with the help of a mirror;
3. Plants and other items brought from the forest may well become a source of ticks for all family members, so it is better to avoid such "souvenirs". Pets should also be examined, because they can become a victim of "bloodsuckers";
4. If you need to spend the night in the forest, it is better to choose places without grass, open areas with sandy soil to minimize the likelihood of tick attacks;
5. The use of repellents applied to the skin, as well as acaricides for treating clothes, helps protect against insects, so this method of prevention should not be neglected. Children should be treated by adults, and when walking with babies, their tendency to put their fingers in their mouths should be taken into account, so it is better to leave the hands untreated.

If the tick nevertheless attacked, then you need to remove it correctly or contact medical institution (trauma center, ambulance station). At home, to extract the “bloodsucker”, the bite site should be lubricated with vegetable oil, and the tick should be captured with tweezers or a thread, tied around the neck, while making swinging movements, as if twisting the insect out of the skin. It happens that when you try to remove a tick, its body comes off, and the head remains in the skin. In such cases, it is necessary to immediately contact a specialist, since the risk of infection remains.

infographic: Belta

Specific prevention of tick-borne encephalitis consists in vaccinating the population of areas endemic for the disease, as well as visitors. Among local residents, the proportion of those vaccinated should not be less than 95%, and special attention is paid to persons whose professional activities are related to being in tick habitats.

The standard of vaccination is the introduction of the drug twice, followed by revaccination once a year. The effect will be if the vaccination is carried out at least two weeks before leaving for the endemic focus or before the start of the epidemic season. Vaccination against tick-borne encephalitis can be done both urgently in case of tick bite, and planned for standard scheme, implying at least one revaccination. Emergency prophylaxis is carried out on the first day after an insect bite.

In addition to tick-borne encephalitis, there are, although much less frequently, secondary inflammatory processes in the brain that complicate the course of other diseases - tumors of the hematopoietic system, sepsis, measles and chickenpox, traumatic injuries. Approaches to therapy in such conditions are determined by the nature of the underlying disease and the symptoms of brain damage.

In case of tick-borne infections, vigilance and caution when visiting the habitats of blood-sucking insects, timely detection and removal of the tick, vaccination and early contact with specialists can significantly reduce the risk of infection, as well as improve the results of therapy in the development of encephalitis.

Video: encephalitis in the program "Live Healthy!"

Encephalitis is an inflammatory process that occurs in the gray or white matter of the brain. It can be caused by a virus, a bacterial process, and even an allergic reaction to an administered serum or vaccine. Symptoms of encephalitis infection can appear unexpectedly when there was no vaccination, no insect bite, or other apparent cause. These may be the so-called sclerosing panencephalitis or Economo's encephalitis, the causes of which have not yet been established.

How is encephalitis diagnosed? Symptoms of the infectious process:

1. Such encephalitis usually begins with prodromal phenomena: cough, sore throat, runny nose. There may be a rash and other manifestations characteristic of chicken pox, measles or rubella, or the disease will be preceded by a purulent process.

2. encephalitis: a severe headache that is usually localized in frontal area or takes over the whole head. It is aggravated by turning the head, sudden movements. It is often accompanied by nausea and vomiting, and the latter can be sudden, without nausea, profuse, and after it it does not get better.

3. Appetite decreases, and it is often impossible to give the patient a drink. Adult patients, being conscious and realizing that it is necessary to drink, are afraid to do this because of nausea or vomiting.

4. Growing weakness, drowsiness.

5. Dizziness.

6. Photophobia.

These signs are very similar to those of meningitis, and isolated meningitis can only be distinguished from encephalitis or meningoencephalitis by MRI.

Symptoms of encephalitis are:

Convulsions, often with respiratory arrest, recurring;

A person can become inadequate, aggressive, then drowsiness increases up to coma;

Sometimes drowsiness increases so quickly that after 6-8 hours the patient cannot be awakened;

There may be respiratory disorders: frequent (more than 20 per minute) or, conversely, rare (8-10 per minute), you can sometimes notice that the intervals between breaths are unequal;

Strabismus;

Unsteadiness of gait;

Numbness in the limbs, a feeling of goosebumps;

Difficulty urinating when there is an urge, but it is impossible to go to the toilet;

Paralysis or paresis (incomplete paralysis);

Swallowing disorder;

Asymmetry of the face and pupils also indicate encephalitis;

There may be other manifestations of encephalitis, such as decreased hearing or vision.

For yourself, you need to remember the following: if such symptoms appear on the background normal temperature, it rises only then, this may mean that a person has a stroke. These diseases are often distinguished only by lumbar puncture and MRI pictures.

is an inflammatory process that occurs in the brain.

It is customary to distinguish between encephalitis primary and secondary . In its turn, primary type diseases include a number of types of encephalitis: tick-borne , epidemic , mosquito , herpetic etc. Encephalitis secondary manifests itself against the background of other diseases: measles , brain , toxoplasmosis and etc.

There is a classification of the disease according to its etiology and pathogenesis: it is customary to distinguish between encephalitis infectious , allergic , infectious-allergic , toxic . At polyencephalitis damage to the gray matter of the brain leukoeicephalitis - white matter. If a person has a lesion of white and gray matter, then in this case there is panencephalitis .

There are also diffuse and limited encephalitis, and according to the course, the disease is divided into spicy , subacute and chronic

epidemic encephalitis

This disease occurs due to exposure to a filterable virus. Infection occurs by contact or airborne droplets. In this case, the incubation period can last from a day to two weeks. The virus enters the body and infects the brain. In the substance and membranes of the brain, inflammation develops, manifested hyperemia . On the acute stage the development of the disease in humans, a sudden increase in body temperature to 38 ° C. If the centers of thermoregulation are affected, then the temperature may be higher. as the main symptom epidemic encephalitis a person is observed pronounced violation sleep: a person constantly stays in or suffers from insomnia. Sleepiness during the day and lack of sleep at night may also be observed. As other symptoms of encephalitis, the occurrence of oculomotor disorders, an inflammatory reaction of the blood of a nonspecific nature, should be noted. The acute phase of the disease lasts about two to three weeks, after which in about half of the cases a person recovers completely or partially. In another 50% of cases, the disease becomes chronic. In this case, the symptoms of encephalitis converge with signs of trembling paralysis. Also, a person may experience changes in the psyche. In the chronic form of the disease, encephalitis can progress, resulting in disability.

Commonly prescribed for the treatment of epidemic encephalitis medicines with antiviral action, dehydrating and desensitizing agents, vitamins.

Tick-borne encephalitis

This disease is exclusively seasonal, occurs in spring and summer. The main source of infection are ixodid ticks that live in wooded areas. Tick-borne encephalitis manifests itself after the penetration of the virus into the body due to the bite of an infected tick. In more rare cases, infection occurs through the alimentary route, for example, after drinking milk from infected animals. The incubation period of the disease can last from 8 to 20 days; if the bite hits the head, then the incubation period is shortened and lasts from 4 to 7 days. The disease begins with an acute course: a person suffers from vomiting, severe headache, photophobia. The body temperature rises sharply, reaching 39-40°C. Sometimes with tick-borne encephalitis, repeated hyperthermia occurs. In this case, the symptoms of encephalitis are even more pronounced. The patient manifests hyperemia of the sclera, pharynx, skin, various dyspeptic disorders. On blood tests, there is an increase leukocytosis , lymphopenia . In especially serious cases, the respiratory muscles may be affected, and bulbar disorders may appear.

Tick-borne encephalitis has several clinical forms: polio , meningeal , polioencephalomyelitis , cerebral and erased .

At meningeal the form of tick-borne encephalitis manifests pronounced meningeal symptoms. In humans, due to inflammation of the brain and its membranes, disorders of consciousness occur, epileptic seizures, delirium, . There may be manifestations of convulsions with the likelihood of their transition to a general convulsive seizure.

With encephalitis polioencephalomyelitis forms in the patient is manifested flaccid paralysis muscles of the shoulder girdle, neck. Possible manifestation of bulbar and shell disorders.

In patients with full myelitic a form of encephalitis, paralysis of the neck, arms, and the patient's head hangs unnaturally on the chest as symptoms. The sensitivity of a person is not disturbed, however, a failure of motor functions is manifested. At erased form of tick-borne encephalitis for two to four days, the patient is observed, neurological symptoms do not appear, but are present, periodic attacks of arterial hypertension. Also stands out progredient a form of the disease in which there are periodic twitches of certain muscle groups. Basically it is the muscles of the arms and neck.

Japanese encephalitis

Japanese encephalitis (other name - ) provokes a virus that mosquitoes store and carry. Carriers of viruses can sometimes be birds, people. In this case, the incubation period lasts from three to twenty-seven days. The disease begins to manifest itself acutely: the body temperature rises sharply to 40 ° C and above, without falling for about 10 days. The patient is annoyed by general malaise, chills, weakness, severe headaches, vomiting, muscle pain. There is hyperthermia of the skin of the face, dryness of the tongue, the stomach is strongly drawn in. Disturbances in cordial activity and in consciousness of the patient are also possible. There is an increase in the tone of the flexors of the upper extremities and at the same time the extensors of the lower extremities. Sometimes there are twitching of some muscles, periodic convulsions. In severe cases, the disease may manifest bulbar paralysis. With this disease, death occurs in about 50% of cases.

Other forms of encephalitis

Against the backdrop of the flu manifests itself influenza encephalitis (other name - toxic-hemorrhagic ). With inflammation of the brain of this type, neurological symptoms appear against the background of signs of influenza. The main symptoms of encephalitis are severe headaches, nausea,. Moving the eyeballs, a person feels pain. There may be manifestations of pain in the back, muscles of the arms, legs, as well as at exit points. trigeminal nerve. Influenza encephalitis can provoke anorexia, sleep problems.

For meningoencephalitis the manifestation of paresis, paralysis, coma is characteristic, and also in some cases epileptic seizures can be observed. At toencephalitis e, which can develop about 3-5 days after the patient develops a rash, there is a lesion of mainly white matter, both head and spinal cord. With the development of this form of encephalitis, the condition of patients worsens again, body temperature rises. Symptoms of encephalitis in this case can be different. So, some patients complain about general manifestation weakness, drowsiness, which can turn into a coma. Other patients experience delirium and impaired consciousness, epileptic seizures, they may periodically be in an agitated state. Possible paralysis, hemiparesis, damage to the facial and optic nerve.

Encephalitis also manifests itself in patients with chicken pox. In this case, the symptoms of the disease occur on the 2-8th day. The nervous system is damaged. The onset of encephalitis is acute: paralysis, paresis, epileptic seizures, hyperkinesis are possible. Coordination may be impaired, and in some cases damage to the optic nerves occurs.

Diagnosis of encephalitis

As methods for diagnosing encephalitis of various forms, a study of cerebrospinal fluid is used. With encephalitis, lymphocytic pleocytosis, a moderate increase in protein levels, is observed in it. flow out occurs at high pressure. A blood test is also done. With encephalitis, an increase in ESR, leukocytosis is observed. In the study of EEG in the presence of diffuse non-specific changes. Magnetic resonance imaging reveals hypodense local changes brain. In addition to these studies, bacteriological and serological studies are carried out to identify the virus - the causative agent of the disease.

Treatment of encephalitis

After the diagnosis » is established, the patient must be immediately admitted to a hospital - in a neurological or infectious diseases department. It is important for the patient to observe the strictest bed rest and be under the constant supervision of a specialist.

At the first stage of treatment, dehydration agents are used. If the patient has pronounced meningeal and encephalitic signs (especially severe headaches and muscle pain, vomiting,), he is prescribed an injection isotonic solution sodium chloride. Also, in parallel with these drugs are prescribed, B vitamins .

In the acute period of the disease, it is used for treatment and those drugs that activate its production; used in the treatment and desensitizing agents.

In the treatment of tick-borne encephalitis in acute period diseases apply , , and also introduce an inactivated cultural vaccine against tick-borne encephalitis. With polyseasonal encephalitis, immediate hospitalization is indicated. In addition to these drugs, this form of the disease is used.

If the patient has a serious condition, intensive care measures are immediately taken. In the case of an epileptic seizure, it is possible to administer the drug ().

In order to activate the process of microcirculation and dehydration, in the treatment of encephalitis, . In influenza encephalitis, glucocorticoids have been successfully used.

Patients with herpetic encephalitis are prescribed in the first days of treatment. It is very important to dress properly before going to the forest or to the mountainous wooded area. It is not necessary to leave parts of the body easily accessible to insects open: the shirt should have long tight sleeves, the presence of a headdress is important. Also on such a trip it is worth taking means against blood-sucking insects.

It is important to inspect after going to the forest: ticks especially often stick on the neck, in the groin, in auricles, in the armpit. Do not drink the milk of animals that are at high risk of infection. The tick should not be crushed, because encephalitis can be infected even if there are small cracks on the hands.

If a person feels unwell after traveling to an area with increased risk infection with encephalitis, you should immediately consult a doctor.

List of sources

• Lobzin Yu. V., Pilipenko V. V., Gromyko Yu. N. Meningitis and encephalitis. - St. Petersburg: 2001.
• Differential diagnosis of nervous diseases / Ed. G.A. Akimova, M.M. Alone. - Publishing house "Hippocrates", 2001.
• Leonova G.N. Tick-borne encephalitis: topical aspects. M.: Publisher I.V. Balabanov, 2009.
• Pokrovsky V.I., Pak S.G., Briko N.I., Danil-kin B.K. infectious diseases and epidemiology. -M.: GEOTAR-Med, 2003.
• Khodos H. G. Nervous diseases.- Moscow.-2001.

Encephalitis - inflammatory lesion brain. As a rule, the progression of this dangerous pathology in children and adults is provoked by infectious agents. Clinicians distinguish between primary and secondary encephalitis of the brain. The primary progresses on its own, while the secondary occurs against the background of various ailments - measles, toxoplasmosis, influenza, and so on.

Primary encephalitis includes the following forms:

• mosquito;
• tick-borne;
• epidemic or lethargic encephalitis;
• viral encephalitis;
• herpetic.

Encephalitis of the brain is characterized by the manifestation of cerebral signs, intoxication syndrome, as well as damage to one or several parts of the brain at once. It is worth noting that each type of pathology has its own “favorite” localization.

Encephalitis is very dangerous pathology, which has no restrictions regarding gender and age. It can develop in both children and adults. Therefore, at the first signs indicating the progression of the pathology, it is important to immediately contact a medical institution for diagnosis and treatment. If adequate therapy is not carried out, then the consequences of encephalitis can be deplorable.

Etiology

A common cause of the progression of encephalitis is a neuroinfection. It is worth noting that the etiology of the disease directly depends on its type. So, the reasons for the progression of viral encephalitis are: the bite of infected insects (usually carriers are mosquitoes or ticks), penetration into the body of the virus, rabies. Microbial types of illness provokes or.

secondary views develop against the backdrop of:

• And so on.

How the virus enters the human body:

• insect bite (hematogenous route);
• with direct contact;
• alimentary way;
• airborne route.

Symptoms

Symptoms of encephalitis depend on several factors:

• infectious agent;
• features of the course of the pathological process;
• locations of the lesion.

But clinicians identify symptoms that are common to all forms of encephalitis. Since encephalitis is an infectious pathology, it is characterized by a pronounced intoxication syndrome. The following symptoms are also observed:

• rise in temperature to critical values;
• violation of the functioning of the gastrointestinal tract;
• headache;
• gagging;
• a characteristic symptom is the occurrence of epileptic seizures.

Kinds

Epidemic

In the medical literature, this type is also referred to as lethargic encephalitis A. This type affects both adults and children equally. The first symptom of the disease is a rapid rise in temperature to critical levels - up to 40 degrees. The patient notes that there is a severe headache, as well as pain syndrome in the area of ​​the joints. With lethargic encephalitis, a violation of consciousness is not excluded. Gradually, the clinical picture is supplemented by such signs:

• hypersomnia;
• excessive sweating;
• violation respiratory function;
• strabismus;
• dystopia;
• the patient begins to delirious.

Lethargic encephalitis is very dangerous, as it develops rapidly and can lead to the death of the patient if not carried out in a timely manner. adequate therapy. Treatment of patients with this diagnosis is carried out in stationary conditions so that doctors can constantly monitor their general condition. Lethargic encephalitis is one of the most commonly diagnosed forms.

Tick-borne encephalitis

This type refers to primary viral encephalitis. As a rule, it is diagnosed in the spring-summer season. The virus is transmitted with the bite of an infected tick that lives in forests. The disease is diagnosed in adults and children. It is worth noting that it is children who are at risk, as they love to play in gardens, forests and other "green areas". Once in the body, the virus with the bloodstream reaches the target organ - the brain, where it begins to actively develop. The patient has the following symptoms:

• photophobia;
• headache;
• vomiting urge. It is worth noting that it is very difficult to eliminate vomiting;
• fever (up to critical indicators);
• paralysis of the muscular structures of the neck.

Japanese encephalitis

The carrier of infection is an infected mosquito. The incubation period is from three to 27 days. Symptoms of the disease:

• fever (over 40 degrees);
• chills;
• nausea;
• gagging;
• pain syndrome;
• disturbance of consciousness;
• twitching of the legs and arms;
• seizures with convulsions;
• in children, damage to the cranial nerves is often observed.

The mortality rate is quite high. Most often, patients die in the first week of disease progression.

influenza form

Progressing against the background of the flu. Diagnosed in adults and children. Main symptoms:

• headache;
• weakness;
• drowsiness;
• fever;
• weight loss;
• nausea and vomiting.

Often this type of viral encephalitis leads to coma.

Measles encephalitis

This form of pathology is more often diagnosed in children, as it progresses a few days after the measles rash (measles is a disease of childhood).

The patient's condition is gradually deteriorating, there is fever, weakness, stupor. But this clinical picture is not always observed. There are cases when the patient, on the contrary, is agitated, delirious, and he has epileptic seizures. This type of pathology affects the cranial nerves, which leads to transverse, or paralysis.

Chickenpox encephalitis

Chickenpox type of pathology is observed against the background of chickenpox. More often the disease is diagnosed in children. As chickenpox encephalitis progresses, the central nervous system is affected. The patient becomes lethargic, he is constantly sleepy. Later, paralysis of the limbs, epileptic seizures are observed. Characteristic chickenpox type of illness - impaired coordination of movements.

Treatment should be carried out as soon as possible, as chickenpox encephalitis can lead to irreversible consequences.

Herpetic type

The causative agent of pathology is the herpes virus. The main "target" is the cerebral cortex. Rapid flow is not typical for this type. Main symptoms:

• fever;
• gagging;
• headache;
• disturbance of consciousness.

As the disease progresses, the clinic is supplemented by the following symptoms:

• human movements are chaotic;
• aphasia;
• apraxia.

Therapy

Diagnosis and treatment of the disease in children and adults is carried out by an infectious disease doctor. If the diagnosis has been confirmed, then the patient is immediately placed in a hospital, in the infectious diseases department. Strict bed rest is shown. The patient's condition is constantly monitored.

The treatment plan is developed strictly individually, taking into account the type of pathology, the severity of the course, as well as general condition patient. In the case of the diagnosis of Japanese or tick-borne encephalitis, the patient is prescribed gamma globulin and other antiviral drugs. Antibiotics are included in the treatment plan for purulent processes. It is shown to carry out detoxification therapy.

The treatment plan can be supplemented with such drugs:

• trental;
• glucocorticosteroids (treatment of cerebral edema);
• anticonvulsants;
• analgesics.

Vaccination

Treatment of the disease will not have to be carried out if the prevention of pathology is done in time. One of the most effective methods of protection is vaccination against encephalitis. Of course, she will not be able to save from the bite of an infected insect, but she will save her from the consequences. Active substance The vaccine contains non-live encephalitis virus. It is introduced into the bloodstream, where it is recognized the immune system and begins to actively develop antibodies to it.

Most often, doctors administer to patients a cultured, purified, concentrated, inactivated dry vaccine. It can be administered to children from 3 years old, as well as adults. But there are some contraindications:

• you can not administer the vaccine against encephalitis in the presence of acute ailments. It is allowed to vaccinate only one month after full recovery;
• a contraindication to vaccination is the bearing of a child;
• do not vaccinate people who have had other vaccinations less than a month ago;
• food allergy is also a contraindication for vaccination, as well as an allergy to medications;
• diseases connective tissue;
• chronic diseases that are in the acute stage at the time of vaccination.

It is important to consider contraindications, since if you get vaccinated in the presence of at least one of these conditions, you can provoke a deterioration in the general condition.

Is everything correct in the article with medical point vision?

Answer only if you have proven medical knowledge

Cerebral encephalitis is a disease of the brain associated with inflammatory reactions and is caused by the penetration of an infection, virus or foreign protein into the substance of the brain and affecting the nervous system.

Of the most common causes of brain encephalitis, viruses are distinguished that occupy a leading position (mosquito virus, tick-borne encephalitis).

There are two ways of transmission of encephalitis:

1. When bitten by a blood-sucking insect (tick, comor).
2. By drinking the milk of an infected animal.

This group is characterized by natural foci, spring-summer seasonality.

Enteroviruses (Coxsackie, ECHO) can also be pathogens. Enteroviral encephalitis is characterized by vomiting, paralysis of the extremities, epileptic seizures. Herpesviruses (herpes simplex virus, herpes zoster, cytomegalovirus infection), retroviruses, myxoviruses (influenza virus, parainfluenza).

More than eighty percent of the population is infected with the herpes simplex virus, but it is in a state of sleep, as soon as the immune system reduces its activity, it begins to activate. To date, there is a trend towards the emergence of encephalitis, which causes the rabies virus. With the development of meningoencephalitis, mycobacteria, spirochetes, streptococci, meningococci, rickettsiae can become causes of brain encephalitis.

Varieties

According to the timing, encephalitis of the brain can be primary and secondary:

There are the following forms of encephalitis:

1. bacterial - occurs due to the penetration of various bacteria into the brain, which begin to destroy its cells, the risk group is people with reduced immunity, the elderly, newborns.
2. fungal encephalitis - defeat is possible only in the presence of concomitant pathology, such as HIV infection. Mushrooms of the genus Candida are very difficult to treat, therefore, as a rule, it leads to death.
3. viral encephalitis develops against the background of penetration into the structures of the brain of the virus, the type of which will depend on the clinical picture. This option can be as a complication, such as vaccination.

If you create a separate group according to the classification of encephalitis of the brain of the head according to the nature of inflammation, then it is customary to distinguish the following:

• necrotic;
• hemorrhagic;
• granulomatous;
• mixed;
• purulent encephalitis.

A necrotic lesion is characterized by the presence of areas of necrosis among healthy tissue. Most often, foci of necrosis are located in the temporal lobe. Hemorrhagic encephalitis is characterized by damage to venules and capillaries, with pinpoint or multiple hemorrhages.

When examining the material microscopically, granulomatous encephalitis is characterized by the accumulation of a conglomerate of inflammatory cells. Purulent encephalitis of the brain develops most often with head injuries, when pyogenic flora enters the brain and an abscess develops.

Diagnosis and treatment

Diagnosis of encephalitis is very difficult. Different types of this pathology have similar initial clinical manifestations, which makes it very difficult to differentiate between them for setting accurate diagnosis sick.

To date, the most informative is the study of the patient's cerebrospinal fluid.

To perform a puncture of the spinal cord, the patient must be laid on a hard table, lower limbs should be brought to the stomach, the patient should clasp them with his hands. In most cases, the puncture is performed when the patient is sitting, wrapping his arms around himself, with a chair under his feet to support his legs.

In this case, the patient's back should be bent to the maximum. The doctor conducts preparations: treatment of the puncture site, treats hands, puts on sterile gloves. Helps the doctor nurse, she shows where the iliac spine is, draws a line, and the doctor finds the place where the puncture will be made.

The puncture is done between the third and fourth lumbar vertebra in adults, in children, they are made between the second and third vertebrae. A needle is inserted into the intended place, moving it inward until it feels like a failure. The mandrin is removed, and with encephalitis, the cerebrospinal fluid will flow out under high pressure. The punctate is taken in three sterile test tubes.

One container is sent to bacteriological examination. Another test tube for studying the composition of cells. The third will be sent for serological testing. With encephalitis, there will be pleocytosis, an increase in the amount of protein, in addition to detecting increased amount leukocytes and / or neutrophils, it is possible to detect erythrocytes, due to which the cerebrospinal fluid will have a red color.

In addition, an increase in the level of sugar in the cerebrospinal fluid is characteristic. When conducting serological reactions, it is likely that antibodies of the pathogen can be detected in the cerebrospinal fluid, which can be used to identify and make an accurate diagnosis.

In addition, you need to take general analysis blood, in which signs of the inflammatory process in the body will be visible: increase in ESR, an increase in the number of leukocytes, a shift of the leukocyte formula to the left.

It is also necessary to carry out computed tomography, magnetically resonance imaging, where you can see focal changes of varying density and intensity.

You also need to consult an ophthalmologist with an examination of the fundus. The doctor can detect congestive optic discs, which indicates damage to brain structures.

It is imperative to take blood for sterility in order to identify or, on the contrary, not detect any pathogenic microorganisms circulating in the blood and provoking the development of the disease.

At present, serological reactions have begun to be actively introduced into practice: RN, RSK, RPHA, ELISA.

For a more accurate and detailed diagnosis, you need to make an appointment with a neurologist.

For the treatment of encephalitis, there are some principles:

• direct effect on the pathogen;
• active prevention of edema and swelling of the brain;
• regulation of the function of the respiratory system and the cardiovascular system;
• symptomatic therapy.

Etiotropic therapy is aimed at the pathogen itself. As a rule, it is antiviral therapy. If the patient has herpetic encephalitis, then acyclovir is used. This drug low toxicity and very effective. With cytomegalovirus infection, ganciclovir is used. Antibacterial therapy is indicated for the diagnosis of meningoencephalitis.

Preference is given to penicillin antibiotics. When a diagnosis of viral encephalitis of the brain is established, interferons should be used to stimulate antiviral activity.

Pathogenetic therapy is aimed at combating the symptoms of intoxication, edema and swelling of the structures and substance of the brain, correcting the water-electrolyte balance, acid-base balance. For the purpose of detoxification therapy, solutions of calcium chloride, sodium chloride, a five percent glucose solution, hemodez, polydez are used.

All this is administered intravenously. In addition, it is necessary to add vitamins of group B, ascorbic acid. To combat cerebral edema, mannitol, lasix (furosemide), and glucocorticosteroids (prednisolone) are administered. To improve metabolism in the brain, to combat hypoxia of all tissues, including the brain, piracetam and cerebrolysin are prescribed.

Symptomatic therapy is aimed at treating individual signs this disease. To prevent seizures, diazepam, carbamazepime, phenobarbital are used, drugs are administered intravenously.

If a headache begins with a sharp increase in temperature, then it is worth using non-steroidal anti-inflammatory drugs, such as analgin, diphenhydramine. To prevent the development of an allergic reaction, antihistamines are prescribed parenterally, for example, suprastin, diphenhydramine.

Symptoms of the disease in adults

Signs of manifestation of cerebral encephalitis in adults include general infectious, general cerebral, meningeal (in particular cases) and focal signs.

Common infectious symptoms in adults include:

• general impotence;
• feeling unwell;
• brokenness.

Characterized by sleep disturbance, decreased appetite. There are pains in muscles, joints, bones. Body temperature rises to febrile numbers and above, chills appear. Perhaps the development of rhinorrhea, the appearance of dryness, perspiration, pain in the throat is characteristic. Dyspeptic syndrome (nausea, vomiting, diarrhea, flatulence, rumbling) can also be attributed to this group. In a clinical and biochemical blood test, one can see changes that are characteristic not only of encephalitis, but of any other somatic pathology.

Common brain symptoms include: headache, nausea, vomiting, non-systemic dizziness, mental disorders, generalized epileptic seizures. A disturbance of consciousness is characteristic, which may be due to its oppression (stunning, stopper, coma), or its change (delusions, hallucinations).

Meningeal signs include: a triad of symptoms (headache, vomiting, fever), stiff neck, positive symptom Kernig, Brudzinsky and Lessage.

Focal symptoms are characterized by: local disturbance of sensitivity, decreased muscle strength, hypotonicity, muscle hypertonicity, speech disorders. The patient is unable to read anything, write any word, ceases to recognize objects, to say what they are intended for.

Characterized by impaired coordination of movements, decreased memory or its loss up to amnesia, ringing in the ears, impaired eyeball movements, impaired control over functions pelvic organs, are affected by CNV.

Symptoms of the disease in newborns

The clinic of brain encephalitis in children should be determined by the duration of the process, its localization with a combination with another disease, or it is an independent disease.

It often happens that few people can immediately distinguish cerebral encephalitis in mice from a common cold. The disease can show different manifestations. At first, it is possible to detect in a newborn baby signs of a common acute respiratory disease, and not encephalitis of the brain.

Signs of encephalitis in babies:

• epidemic encephalitis: strabismus, ptosis, drowsiness and apathy;
• herpetic encephalitis also has its own symptoms: an attack of epilepsy is characteristic, in the foreground general infectious symptoms, and then everything else, paralysis and paresis.

Prevention and prognosis

Prevention of this disease is divided into non-specific and specific.

For non-specific prevention of encephalitis, it is necessary to carry out sanitary and educational work with the population, explain the causes of development, the first symptoms, what to do if there are any signs of the disease, it is necessary to protect people and premises from possible carriers, to direct forces to combat rodents.

Specific prophylaxis is aimed at vaccinating decreed groups, which, by the nature of their activities, have to be in endemic areas for encephalitis.

With a mild course of pathology and timely treatment, a quick recovery is observed. At medium degree severity, the rehabilitation period can last up to 6 months, complications can occur when improper treatment, not observing the regimen and precautions. In severe cases, complications may develop, and fatal outcome. At the same time, leukoencephalopathy develops against the background of encephalitis.

There are a number of other complications after the disease:

• non-systemic dizziness, headaches;
• development of meningitis;
• hearing loss, vision loss;
• disturbances in the activity of the cerebellum in the form of a shaky gait, impaired coordination of movements;
• cessation of the respiratory system, subsequently death;
• urinary incontinence;
• decline mental activity, memory;
• mental disorder.

The consequences of the disease depend on the severity of the course of the disease, as well as the age of the patient himself.

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