Epidemiological study on hospitalizations for viral encephalitis in Brazil between january 2010 to december 2020

Introduction: Viral encephalitis (VE) is an inflammation of the brain parenchyma that progresses to neurological dysfunction of infectious origin. It occurs after hematogenous dissemination into the Central Nervous System and the most common agents are herpes virus, influenza, enterovirus, arbovirus, cytomegalovirus and Epstein-Barr. The signs and symptoms are headache, fever, decreased level of consciousness, seizures, focal deficits and behavioral changes. Objective: Recognize the epidemiological pattern of hospitalizations for VE in Brazil, between 2010 and 2020. Methods: A search for original articles and statistical information was performed in the databases Scielo, PUBMED, Medline and DATASUS, the latter related hospitalizations for VE with region, age, gender and year. Results: Hospitalizations are greater between 0 and 14 Y.O. (59.6%) in both genders, being 1.38M: 1F. The data indicate: <1 Y.O. (15%), 1-4 Y.O. (18.1%), 5-9 Y.O. (16.2%), 10-14 Y.O. (10.2%), totalizing 59.5% (21,004) of hospitalizations (35,188) in these groups, also intensified, between 20-29 Y.O., with 3,956 cases (11.2%). Comparing 2010 and 2020 there was a 63.4% reduction in hospitalizations for VE and the Southeast had the highest rate of the disease (42.1%). Conclusion: The epidemiological pattern of VE in the last decade represented higher prevalence in the interval between 0 and 14 Y.O.; mainly from 1 to 4. The decrease in the last 11 years may be due to adherence to vaccination campaigns and increased vector control, while the hypothesis for the higher incidence in the Southeast is because it is the most populous region, with favorable geographical areas for viral dissemination.

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Viral Encephalitis In Adults: A Narrative Review

Reviews on Recent Clinical Trials ◽

10.2174/1574887116666211118141117 ◽

2021 ◽

Vol 16 ◽

Author(s):

Siciliano Valentina ◽

Rosà Tommaso ◽

Del Vecchio Pierluigi ◽

D'Angelillo Anna ◽

Brigida Mattia ◽

...

Keyword(s):

Viral Encephalitis ◽

Viral Infections ◽

Direct Action ◽

Ventilatory Support ◽

Signs And Symptoms ◽

Altered Mental Status ◽

Poor Quality ◽

Electrolyte Disorders ◽

The Central Nervous System

: Viral infections of the central nervous system cause frequent hospitalization. The pathogenesis of viral encephalitis involves both the direct action of invading pathogens and the damage generated by the inflammatory reaction they trigger. The type of signs and symptoms presented by the patient depends on the severity and location of the ongoing inflammatory process. Most of the viral encephalitides are characterized by an acute development, fever, variable alterations in consciousness (confusion, lethargy, even coma), seizures (focal and generalized) and focal neurologic signs. The specific diagnosis of encephalitis is usually based on lumbar puncture. Cerebrospinal fluid examination should be performed in all patients unless absolutely contraindicated. Also, electroencephalogram and neuroimaging play a prominent role in diagnosis. Airway protection, ventilatory support, the management of raised intracranial pressure and correction of electrolyte disorders must be immediately considered in a patient with altered mental status. The only therapy strictly recommended is acyclovir in HSV encephalitis. The use of adjunctive glucocorticoids has poor-quality evidence in HSV, EBV, or VZV encephalitis. The role of antiviral therapy in other types of viral encephalitis is not well defined.

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Viral Encephalitis: A Hard Nut to Crack

Annals of the National Academy of Medical Sciences (India) ◽

10.1055/s-0039-1697767 ◽

2019 ◽

Vol 55 (02) ◽

pp. 098-109

Author(s):

Alka Shukla ◽

Mayank Gangwar ◽

Sonam Rastogi ◽

Gopal Nath

Keyword(s):

Viral Encephalitis ◽

Viral Infections ◽

Neurological Complication ◽

Clinical Signs ◽

Geographical Location ◽

Signs And Symptoms ◽

Climatic Conditions ◽

Altered Level ◽

Level Of Consciousness ◽

Clinical Signs And Symptoms

AbstractViral encephalitis is inflammation of brain that manifests as neurological complication of viral infections. There are quite a good number of viruses, for example, human herpes virus, Japanese encephalitis, and enteroviruses that can result in such a dreadful condition. Geographical location, age, gender, immune status, and climatic conditions also contribute to the establishment of this disease in an individual. Clinical signs and symptoms include fever, headache, altered level of consciousness, changed mental status, body ache, seizures, nausea, and vomiting. Effective management of this disease relies on timely diagnosis that in turn depends on apt and suitable investigation techniques. Traditional investigations have thinned out these days owing to the fact that advanced molecular technologies have been introduced to the diagnostic field. Treatment of viral encephalitis mainly involves symptomatic relieve from fever, malaise, myalgia along with measures to reduce viral load in the patient. This review mentions about all the possible aspects of viral encephalitis starting from etiology to the management and preventive measures that include immunization and vector control.

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Highly reactive anti-myelin oligodendrocyte glycoprotein antibodies differentiate demyelinating diseases from viral encephalitis in children

Multiple Sclerosis Journal ◽

10.1177/1352458510389220 ◽

2010 ◽

Vol 17 (3) ◽

pp. 297-302 ◽

Cited By ~ 62

Author(s):

PH Lalive ◽

MG Häusler ◽

H Maurey ◽

Y Mikaeloff ◽

M Tardieu ◽

...

Keyword(s):

Viral Encephalitis ◽

Acute Disseminated Encephalomyelitis ◽

Myelin Oligodendrocyte Glycoprotein ◽

Demyelinating Diseases ◽

Barr Virus ◽

The Central Nervous System ◽

Mog Antibodies ◽

Epstein Barr ◽

Low Sensitivity ◽

Demyelinating Disorders

Background: Myelin oligodendrocyte glycoprotein (MOG) may be implicated in the immunopathogenesis of multiple sclerosis (MS) inducing demyelination in the animal model of MS. In adults reported anti-MOG antibody frequencies have been variable across a number of studies and can also be detected in controls. Objective: To measure antibodies against MOG in paediatric patients with demyelinating disorders of the central nervous system and in controls. Methods: Serum antibodies against MOG and myelin basic protein were measured by ELISA, flow cytometry (FACS) and in the liquid phase in 11 children with acute disseminated encephalomyelitis (ADEM), 22 children with MS, seven children with acute viral encephalitis and 13 healthy controls. The serostatus of Epstein–Barr virus (EBV) infections were assessed. Results: Anti-MOG antibodies, measured either by ELISA or FACS were exclusively detected in children with demyelination. In ADEM these antibodies were highly reactive. Anti-MBP reactivity was detectable equally in all groups. The presence of either autoantibodies did not associate with EBV serostatus, age, gender or disease course. Conclusions: This study independently corroborates recently published results of seroprevalence and specificity of the assay. Due to their low sensitivity anti-MOG antibodies will not serve as disease-specific biomarkers, but could help to support the diagnosis of ADEM in difficult cases.

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Neurocisticercosis extraparenquimatosa: reto terapéutico A propósito de un caso de la glándula parótida

Studies in the Economic History of Southern Africa ◽

10.22201/fm.24484865e.2020.63.4.03 ◽

2020 ◽

Vol 63 (4) ◽

pp. 19-27

Author(s):

José de Jesús Morales-Sandoval ◽

Carlos Alejandro Téllez-Arellano ◽

Agnés Fleury

Keyword(s):

Magnetic Resonance ◽

Clinical Symptoms ◽

Taenia Solium ◽

Signs And Symptoms ◽

Brain Parenchyma ◽

Sub Saharan Africa ◽

High Prevalence ◽

Great Heterogeneity ◽

The Central Nervous System ◽

Sub Saharan

Introduction:Neurocysticercosis is a parasitosis of the central nervous system, caused by the intake of eggs from taenia solium. It has a high prevalence in certain regions of Latin America, the southeast of Asia, and sub-Saharan Africa, where unhealthy situations still prevail. Clinical case: A 55-year-old woman with clinical symptoms of 2 years of evolution, such as recurrent headaches that had increased recently in addition to tonic-clonic seizures. In these conditions she was admitted to the hospital’s emergency department. Neuroimaging studies (tomography and magnetic resonance imaging) showed the presence of subarachnoid vesicular structures compatible with neurocysticercosis. Therefore, a cestocidal treatment was administered but the patient did not return to her follow-up appointments for 4 years. When she finally went to her appointment, she was very symptomatic and required the administration of 8 cycles of treatment to eradicate the parasites. Discussion: The great heterogeneity and the non-specificity of the signs and symptoms difficult making a diagnosis of neurocysticercosis. Therefore, it is important to look for complementary laboratory and imaging evidence to confirm it. The treatment of neurocysticercosis represents a challenge for the physician. Particularly, when the parasite is located outside the brain parenchyma, subarachnoid cisterns and ventricular system. In less than a third of these patients the parasites disappear with a single cycle of cestocidal treatment. Conclusion: Neurocysticercosis is a disease closely related to poverty, but it is preventable. Research focused on treatments for neurocysticercosis is still necessary. Key words:Neurocysticercosis; taenia solium; seizures; magnetic resonance; cestocidal.

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Clinical features and surgical treatment of epilepsy after viral encephalitis

Brain Science Advances ◽

10.1177/2096595819896177 ◽

2019 ◽

Vol 5 (1) ◽

pp. 41-50 ◽

Cited By ~ 3

Author(s):

Yiou Liu ◽

Wenjing Zhou

Keyword(s):

Surgical Treatment ◽

Viral Infection ◽

Clinical Features ◽

Viral Encephalitis ◽

Brain Parenchyma ◽

Neurological Sequelae ◽

Symptomatic Seizures ◽

The Central Nervous System ◽

Underlying Mechanisms ◽

Acute Symptomatic Seizures

Encephalitis is an acute inflammatory process of the brain parenchyma, which is often caused by viral infection. It is an vital cause of acute symptomatic seizures and subsequent epilepsy. The incidence of unprovoked and recurrent seizures after previous infections of the central nervous system is high and accounts for 1%~5% of the cases of epilepsy. Viral encephalitis (VE) is directly caused by viral infection. The occurrence of seizures after VE is associated with poor prognosis. In survivors of VE, among other neurological sequelae, the risk of developing epilepsy is increased 10-fold. The risk of severe neurological sequelae after VE is particularly high in very young children. Studies on seizure occurrence, possible underlying mechanisms, clinical characteristics, and clinical treatment (especially surgical treatment) of VE have yielded only limited detailed data. We reviewed the most recent literature on the clinical features and surgical treatment of post-VE epilepsy.

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Uncommon manifestations of a rare disease: a case of autoimmune GFAP astrocytopathy

BMC Neurology ◽

10.1186/s12883-021-02070-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Hong Di ◽

Yue Yin ◽

Ruxuan Chen ◽

Yun Zhang ◽

Jun Ni ◽

...

Keyword(s):

Rare Disease ◽

Hormone Secretion ◽

White Matter Lesions ◽

Signs And Symptoms ◽

Careful Examination ◽

Case Presentation ◽

Inappropriate Antidiuretic Hormone Secretion ◽

Contrast Enhanced ◽

The Central Nervous System ◽

Magnetic Resonance Imaging Mri

Abstract Background Manifestations of intractable hyponatremia and hypokalemia in autoimmune glial fibrillary acidic protein (GFAP) astrocytopathy have been rarely reported. Case presentation A 75-year-old male patient presented as the case of syndrome of inappropriate antidiuretic hormone secretion (SIADH) and intractable hypokalemia, showed fever, fatigue, and mental disorders. Signs and symptoms of meningoencephalitis, ataxia, and cognitive abnormalities. Magnetic resonance imaging (MRI) revealed multiple white matter lesions of the central nervous system. He had GFAP-IgG in the cerebrospinal fluid (CSF). After treatment with corticosteroids, his symptoms were alleviated gradually, and the level of electrolytes was normal. However, head contrast-enhanced MRI + susceptibility-weighted imaging (SWI) showed a wide afflicted region, and the serum GFAP-IgG turned positive. Considering the relapse of the disease, ha was treated with immunoglobulin and mycophenolate mofetil (MMF) to stabilize his condition. Conclusion This case showed a rare disease with uncommon manifestations, suggesting that careful examination and timely diagnosis are essential for disease management and satisfactory prognosis.

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Lyme Disease: Acute Focal Meningoencephalitis in a Child

PEDIATRICS ◽

10.1542/peds.82.6.931 ◽

1988 ◽

Vol 82 (6) ◽

pp. 931-934

Author(s):

HENRY M. FEDER ◽

EDWIN L. ZALNERAITIS ◽

LOUIS REIK

Keyword(s):

Nervous System ◽

Case Report ◽

Lyme Disease ◽

Signs And Symptoms ◽

Brain Parenchyma ◽

Tick Bite ◽

System Involvement ◽

History Of ◽

Csf Pleocytosis ◽

The Brain

Nervous system involvement in Lyme disease was originally described as meningitis, cranial neuritis, and radiculoneuritis,1-3 but Lyme disease can also involve the brain parenchyma. We describe a child whose first manifestation of Lyme disease was an acute, focal meningoencephalitis with signs and symptoms such as fever, headache, slurred speech, hemiparesis, seizure, and CSF pleocytosis. CASE REPORT A 7-year-old boy was hospitalized Aug 27, 1985, because of hemiparesis. Six weeks prior to admission he had vacationed at Old Lyme, CT. There was no history of rash or tick bite. He had been well until eight hours prior to admission when fever and headache developed.

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Superficial siderosis of the central nervous system is a rare and possibly underdiagnosed disorder

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x20170001 ◽

2017 ◽

Vol 75 (2) ◽

pp. 92-95 ◽

Cited By ~ 3

Author(s):

Yara Dadalti Fragoso ◽

Tarso Adoni ◽

Joseph Bruno Bidin Brooks ◽

Sidney Gomes ◽

Marcus Vinicius Magno Goncalves ◽

...

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Disease Onset ◽

Clinical Findings ◽

Neurological Dysfunction ◽

Superficial Siderosis ◽

Blood Products ◽

The Central Nervous System ◽

Magnetic Resonance Imaging Mri ◽

Intermittent Bleeding

ABSTRACT Superficial siderosis (SS) of the central nervous system (CNS) is a rare and possibly underdiagnosed disorder resulting from chronic or intermittent bleeding into the subarachnoid space, leading to deposition of blood products in the subpial layers of the meninges. Magnetic resonance imaging (MRI) shows a characteristic curvilinear pattern of hypointensity on its blood-sensitive sequences. Methods Series of cases collected from Brazilian centers. Results We studied 13 cases of patients presenting with progressive histories of neurological dysfunction caused by SS-CNS. The most frequent clinical findings in these patients were progressive gait ataxia, hearing loss, hyperreflexia and cognitive dysfunction. The diagnoses of SS-CNS were made seven months to 30 years after the disease onset. Conclusion SS-CNS is a rare disease that may remain undiagnosed for long periods. Awareness of this condition is essential for the clinician.

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Intracerebral haemorrhage in Down syndrome: protected or predisposed?

F1000Research ◽

10.12688/f1000research.7819.1 ◽

2016 ◽

Vol 5 ◽

pp. 876 ◽

Cited By ~ 18

Author(s):

Lewis Buss ◽

Elizabeth Fisher ◽

John Hardy ◽

Dean Nizetic ◽

Jurgen Groet ◽

...

Keyword(s):

Down Syndrome ◽

Intracerebral Haemorrhage ◽

Early Onset ◽

Epidemiological Data ◽

Haemorrhagic Stroke ◽

Brain Parenchyma ◽

Chromosome 21 ◽

Clinical Consequence ◽

Increased Risk ◽

The Central Nervous System

Down syndrome (DS), which arises from trisomy of chromosome 21, is associated with deposition of large amounts of amyloid within the central nervous system. Amyloid accumulates in two compartments: as plaques within the brain parenchyma and in vessel walls of the cerebral microvasculature. The parenchymal plaque amyloid is thought to result in an early onsetAlzheimer’s disease (AD) dementia, a phenomenon so common amongst people with DS that it could be considered a defining feature of the condition. The amyloid precursor protein (APP) gene lies on chromosome 21 and its presence in three copies in DS is thought to largely drive the early onset AD. In contrast, intracerebral haemorrhage (ICH), the main clinical consequence of vascular amyloidosis, is a more poorly defined feature of DS. We review recent epidemiological data on stroke (including haemorrhagic stroke) in order to make comparisons with a rare form of familial AD due to duplication (i.e. having three copies) of the APP region on chromosome 21, here called ‘dup-APP’, which is associated with more frequent and severe ICH. We conclude that although people with DS are at increased risk of ICH, this is less common than in dup-APP, suggesting the presence of mechanisms that act protectively. We review these mechanisms and consider comparative research into DS and dup-APP that may yield further pathophysiological insight.

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Vascular Dysfunction Induced by Mercury Exposure

International Journal of Molecular Sciences ◽

10.3390/ijms20102435 ◽

2019 ◽

Vol 20 (10) ◽

pp. 2435 ◽

Cited By ~ 4

Author(s):

Tetsuya Takahashi ◽

Takayoshi Shimohata

Keyword(s):

Oxidative Stress ◽

Vascular Dysfunction ◽

Brain Parenchyma ◽

Transport Systems ◽

Mehg Exposure ◽

In Vivo Models ◽

The Central Nervous System ◽

The Brain

Methylmercury (MeHg) causes severe damage to the central nervous system, and there is increasing evidence of the association between MeHg exposure and vascular dysfunction, hemorrhage, and edema in the brain, but not in other organs of patients with acute MeHg intoxication. These observations suggest that MeHg possibly causes blood–brain barrier (BBB) damage. MeHg penetrates the BBB into the brain parenchyma via active transport systems, mainly the l-type amino acid transporter 1, on endothelial cell membranes. Recently, exposure to mercury has significantly increased. Numerous reports suggest that long-term low-level MeHg exposure can impair endothelial function and increase the risks of cardiovascular disease. The most widely reported mechanism of MeHg toxicity is oxidative stress and related pathways, such as neuroinflammation. BBB dysfunction has been suggested by both in vitro and in vivo models of MeHg intoxication. Therapy targeted at both maintaining the BBB and suppressing oxidative stress may represent a promising therapeutic strategy for MeHg intoxication. This paper reviews studies on the relationship between MeHg exposure and vascular dysfunction, with a special emphasis on the BBB.

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