Encephalitis in an acute inflammation of the brain. Caused by herpes simplex virus, encephalitis causes cerebral edema thereby destroying nerve cells. This may lead to bleeding in the brain and brain damage. Encephalitis is often caused by the virus that causes mumps, measles, rabies, polio and rubella. Symptoms of encephalitis may begin with a stomach infection, headache and fever. It can also manifest in vomiting, drowsiness and clumsy gait. Severe headache and muscle or loss of consciousness are severe symptoms.
Brain MRI and CT scan of the head might be necessary to diagnose encephalitis. Serology tests and lumbar puncture and CSF examination might be done. Examination of the patient might show increased intracranial pressure, abnormal reflexes and mental confusion. The patient is given nutrition through fluids and anti-viral medicines such as acyclovir and foscarnet. Anti-seizures might be given. Antibiotics are prescribed in case the infection is caused by bacteria.
Paroxysm refers to sudden fits or outbursts. These paroxysmal attacks are short and usually frequent. Paroxysmal attacks are associated with pertussis, encephalitis, heat trauma, multiple sclerosis and epilepsy. A paroxysm is most often triggered by anxiety, neck flexion and anger.
Optic Disk Swelling
A doctor checks into the eye with an ophthalmoscope when there are regular complaints of headache, nausea or vomiting. This is to check for the appearance of the optic nerve and the blood vessels that pass through the eye. Swelling of the optic nerve is called Papilledema.
The optic nerve is a thick cord that connects the back of each eyeball and its retina to the brain. The cerebral spinal fluid protects the nerve between the brain and eye. Even if there is a slight increase in the pressure of this fluid, due to swelling in the brain, the optic nerve can get compressed around its whole circumference in a choking manner. The optic nerve can bulge whenever it develops inflammation on its own - causing Papilledema.
Such swelling of the optic nerve head can also be caused due to intracranial pressure. This could be due to an underlying brain tumor or brain infection such as abscess, meningitis or encephalitis. In fact many who are diagnosed with brain tumors exhibit Papilledema. Sometimes this can be caused due to high blood pressure.
Causes of Papilledema :
- Tumor of the Brain, Skull, Spinal column or cord, optic nerve
- Hydrocephalus - accumulation of cerebrospinal fluid within the skull
- Intracranial infections such as encephalitis, meningitis
- Abscess - Accumulation of Pus, Hemorrhage or trauma to the head
- Craniosynostosis - Abnormal closure of the skull bones
Symptoms of Papilledema :
- Headaches - especially the types which become severe on awakening; headaches that become exacerbated by coughing or holding breath
- Nausea and Vomiting
- Changes in vision manifesting in the form of double vision, flickering, transient blurring or graying
Pseudo tumor cerebri or benign intracranial hypertension is one condition which can cause increased pressure in the cerebral spinal fluid. This is caused when the body makes too much spinal fluid. This is common in women especially who are obese and of child bearing age, and at such times when the body is adjusting to hormone changes such as pregnancy, the first menstrual period or menopause. It is better to go in immediately for neuro-imaging and MRI to check the cerebral cenous sinuses. A lumbar puncture could be done to check the opening pressure as well as CSF (cerebro spinal fluid) test, Fluorescein Angiography - an eye test specifically intended to check the blood flow in the Retina and Choroid, if there is diagnostic uncertainty. In some cases ultrasonography and Retinal Tomography may be used to get 3D data and image.
Although a swollen optic nerve tends to improve over a period of time, it may take months for complete restoration of normal vision. Doctors usually treat with intravenous steroid drugs but this process may have little effect on vision in some cases, although it may help to improve overall health.