Epidemic encephalitis (lethargic encephalitis A).
The reasons
The causative agent of the disease is a filterable virus that is transmitted by airborne droplets or contact. The virus enters the body through the nose and throat. The incubation period is from 1 to 14 days.
Epidemic encephalitis is characterized by early viremia and hematogenous dissemination of viruses with involvement of internal organs, especially the liver. The virus can spread through the lymphatic tract and perineurally.
It affects the central gray matter of the aqueduct of the brain, the tires of the quadrigemina, the legs of the brain, the nuclei of the hypothalamic region, the substantia nigra. Persons of any age get sick.
Symptoms
The acute stage is characterized by a rapid increase in body temperature up to 39 – 40 ° C, catarrhal phenomena, headache, lethargy, joint pain, impaired consciousness. Sleep disorders are observed – hypersomnia, insomnia and sleep inversion. They last for 1-2 months.
Oculomotor disorders develop – diplopia, ptosis, strabismus, paresis or gaze paralysis. Autonomic disorders are also noted – hyperhidrosis, lability of vasomotors, tachycardia, changes in the rhythm of breathing.
Such signs as “greasy face”, hypersalivation are characteristic. Possible mental disorders (euphoria, impaired consciousness or delirium). Some patients have hiccups.
The acute stage of the disease lasts from 10-12 days to 2-3 months. During this time, the symptoms of focal lesions gradually decrease and do not often disappear. Among the residual effects, hypothalamic disorders, hyperkinesis, astheno-neurotic syndrome with irritability, decreased attention and memory, and night terrors are more often noted.
Diagnostics
The diagnosis is made in the presence of hypersomnic-ophthalmoplegic syndrome. The basis for the diagnosis of the chronic form of E. are the anamnesis data and the progressive increase in parkinsonism, hypothalamic syndrome, and psychopathic behavior.
Treatment
In cases of acute form, immunoprotectors are used, in particular prodigiosan (0.005% or 0.01% solution of 0.25 ml intramuscularly 1 time in 3-4 days), which stimulates the production of interferon and activates immunological reactions. As anti-inflammatory drugs use acetylsalicylic acid, analgin. Carry out dehydration therapy. Showing vitamins, nootropics.
Dopamine products are most effective in the development of parkinsonism