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Encephalitis is an acute inflammation of the brain usually caused by a viral infection. The course of viral encephalitis varies. Most people infected with viral encephalitis have only mild or no symptoms, and the illness doesn't last long. Serious cases can cause headaches, high fevers, lethargy, convulsions, delirium, coma, and even death, or may leave significant mental impairment. Impairment can include loss of memory, the inability to speak coherently, lack of muscle coordination, paralysis, or hearing or vision defects.

Warning Signs and Symptoms of Encephalitis

There are several warning signs and symptoms that may be result of encephalitis. Somoe of these are mild and non-specific, while others are severe and require immediate attention. Among the signs and symptoms for encephalitis are:

  • Drowsiness;
  • Confusion and disorientation;
  • Seizures;
  • Sudden fever;
  • Severe headache;
  • Nausea and vomiting;
  • Tremors;
  • Bulging in the soft spots (fontanelles) of the skull in infants;
  • Stiff neck - occasionally; and
  • Photophobia (abnormal visual sensitivity to light).
Emergency signs and symptoms may include seizures, muscle weakness, and altered levels of consciousness. In infants, the key symptoms are a stiff neck and a bulging in the soft spots of the skull (fontanelles). In older children, the initial symptoms may be a severe headache and sensitivity to light. In adults, mental disturbances may be more prominent as an initial symptom.

Diagnosing Encephalitis

The diagnosis of encephalitis once sings and symptoms appear may involve one or more of the following tests:

  • Spinal tap (lumbar puncture) The most common way to diagnose encephalitis is to analyze the cerebrospinal fluid surrounding your brain and spinal cord. A needle inserted into the spine extracts a sample of fluid for laboratory analysis. Analysis of the fluid may reveal presence of an infection or an increased white blood count, a signal that the your immune system is fighting an infection. If hemorrhages have occurred, the your cerebrospinal fluid may be slightly bloody. Diagnosis of herpes simplex encephalitis is sometimes difficult. Advances using sensitive deoxyribonucleic acid (DNA) methods have allowed detection of virus in the spinal fluid, confirming the diagnosis.
  • Electroencephalography (EEG) This procedure, measures the waves of electrical activity produced by the brain. It is often used to diagnose and manage seizure disorders. Electrodes are attached to the scalp, and the patient is asked to still and to breathe deeply and steadily for several minutes or to stare at a patterned board. At times, a light may be flashed in the patient's eyes. These actions are meant to stimulate your brain. The electrodes pick up the electrical impulses from the brain and send them to the EEG machine, which records the brain waves on a moving sheet of paper.
  • Brain imaging A computerized tomography (CT) or magnetic resonance imaging (MRI) scan may reveal swelling of the brain. This swelling may be localized in herpes simplex encephalitis. The scan may reveal another condition with signs and symptoms similar to encephalitis, such as a concussion.
  • Brain biopsy Rarely, if diagnosis of herpes simplex encephalitis wasn't possible using DNA methods or by CT or MRI scans, a small sample of brain tissue may be taken. This sample will be analyzed in the laboratory to see if the virus is present. The patient may receive treatment first with an antiviral agent. If the patient does not improve with antiviral treatment, then the doctor may suggest a brain biopsy.

Treating Encephalitis

To treat encephalitis in the early stages of the illness, an antiviral agent may be prescribed. An anticonvulsant medication may need to be prescribed to prevent or treat seizures. Anti-inflammatory drugs or medications that reduce brain swelling and inflammation and reduce pressure within the skull also may also need to be used. Treatment should be started early in the course of the disease.

Complications from Delayed Treatment

The prognosis for encephalitis varies. Some cases are mild, short and relatively benign and patients make a full recovery. Other cases are severe, and permanent impairment or death is possible without immediate diagnosis and treatment. With early diagnosis and prompt treatment, most patients recover.

The severity of complications from encephalitis can increase the longer the disease is present without treatment. Complications include:

  • respiratory arrest;
  • coma;
  • marked mental impairment;
  • memory loss;
  • paralysis;
  • inability to speak coherently;
  • hearing and vision damage; and
  • death

Medical Malpractice

If encephalitis is detected and properly treated before it advances, the chances of survival without serious consequences is significantly better than if the encephalitis is not detected and treated until it has reached a more advanced stage. Any undue delay in diagnosing or treating encephalitis can have tragic consequences. Unfortunately, too often warning signs are ignored, and treatment is delayed. The following are among the more common forms of negligence or medical malpractice by physicians in diagnosing and/or treating patients with encephalitis:

  • Failing to test for encephalitis when a patient reports warning signs or symptoms that can be caused by encephalitis
  • Delaying the diagnosis of encephalitis
  • Failing to order appropriate treatment for a patient with encephalitis
  • Failing to follow-up with the patient
The above are only examples and are by no means intended to be an exhaustive list of acts of malpractice.

If you or someone you love have suffered from serious complications of encephalitis due to the neglect of a physician or other health care provider, you should immediately contact a competent attorney. The attorney will work with you to determine legal options that may be available.

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Law Office of Joseph A. Hernandez, P.C.
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