Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content ++ MeningoencephalitisAcute disseminated encephalomyelitis ++ 323.9 Unspecified cause of encephalitis, myelitis, encephalomyelitis ++ G04.90 Encephalitis and encephalomyelitis, unspecified ++ 5A: Primary Prevention/Risk Reduction for Loss of Balance and Falling5C: Impaired Motor Function and Sensory Integrity Associated with Nonprogressive Disorders of the Central Nervous System – congenital origin or acquired in infancy or childhood5D: Impaired Motor Function and Sensory Integrity Associated with Nonprogressive Disorders of the Central Nervous System – acquired in adolescence or adulthood5I: Impaired Arousal, Range of Motion and Motor Control Associated with Coma, Near Coma, or Vegetative State +++ Description ++ Infection of the brain parenchymaMost commonly results in infection of the entire brain, but some viruses attack specific nervous system structures +++ Essentials of Diagnosis ++ May occur with meningitis; some overlap of signs and symptomsTwo primary forms: viral and bacterialPost-infectious encephalitis: autoimmune reaction to systemic viral infectionCausative factor must be identified to initiate appropriate medical treatment prior to physical therapy involvementCommon forms includeHerpes simplex encephalitis (most common in adults: sporadic encephalitis)Arboviral encephalitis Most common epidemic forms: West Nile virus, Eastern and Western equine encephalitis, rabies +++ General Considerations ++ Rapid differential diagnosis of encephalitis vs. meningitis should be made due to similarities of initial symptoms and response to medication Severity may progress over a period of 1 week; PT should monitor for changing neurologic signs and symptoms, refer accordingly +++ Demographics ++ Approximately 20,000 cases of acute viral encephalitis are reported annually in the United StatesDeath occurs in 5 to 20%All ages and genders susceptible; some forms more common in specific geographic locations +++ Signs and Symptoms ++ FeverHeadacheNuchal rigidityVomitingGeneral malaiseComaCranial nerve palsyHemiplegiaInvoluntary movementsAtaxia +++ Functional Implications ++ Inability to perform ADLs independentlyLoss of independent functional mobilityInability to perform age and education appropriate cognitive tasks Inability to execute fine and gross motor tasks independently +++ Possible Contributing Causes ++ Increased risk to individuals who areImmunosuppressedPerinatal to early childhood periodPrior meningitis +++ Differential Diagnosis ++ StrokeSubdural empyemaCerebral abscessCerebral venous thrombosisSeptic embolismMeningitis +++ Laboratory Tests ++ Cerebral spinal fluid testingIntracranial pressure +++ Imaging ++ CT scan for detailed imaging MRI with gadolinium enhancement +++ Medications ++ Antiviral agentsCorticosteroids if cerebral edema present ++ To ER if encephalitis suspectedTo neurologist during infection and for follow-upTo physician for respiratory therapy if source of infection is pulmonary in originTo occupational therapist for ADL- and cognitive-retrainingTo social ... Your Access profile is currently affiliated with [InstitutionA] and is in the process of switching affiliations to [InstitutionB]. Please select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.