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Related Concept Videos

Encephalitis l: Introduction01:19

Encephalitis l: Introduction

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Encephalitis is inflammation of the brain parenchyma, most often due to infections or autoimmune processes. It presents with neuropsychiatric features such as fever, altered mental status, behavioral changes, cognitive dysfunction, seizures, focal deficits, and sometimes autonomic instability. In some cases, the meninges are also involved, resulting in meningoencephalitis.Infectious CausesInfectious encephalitis is most commonly viral but can also result from bacterial, fungal, or parasitic...
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Encephalitis is inflammation of the brain parenchyma caused by direct viral invasion or immune-mediated mechanisms triggered by infections or tumors. Both processes lead to neuronal injury, disrupted neurotransmission, and diverse neurological symptoms, often with overlapping clinical and pathological features.Autoimmune EncephalitisIn autoimmune encephalitis, antibodies target neuronal antigens on cell surfaces, synapses, or within neurons. A key example is anti-NMDAR encephalitis, which can...
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Arboviral Encephalitis

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Arboviral encephalitis refers to brain inflammation caused by arthropod-borne viruses, particularly those transmitted through mosquito vectors. Among these, West Nile virus (WNV), a member of the Flaviviridae family, is a significant public health concern. WNV is an enveloped, positive-sense, single-stranded RNA virus. Human infection typically begins when an infected mosquito introduces the virus into the dermis during feeding. The primary transmission cycle involves birds as amplifying hosts...
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Glutamate is a fundamental neurotransmitter in the central nervous system, playing a vital role in neuronal communication and various cognitive processes. Glutamate stands as the principal excitatory neurotransmitter in the brain. Its presence is crucial for the communication between neurons, underpinning essential processes such as synaptic transmission, neuronal excitability, and plasticity. These functions are vital for higher-order cognitive processes, including learning and memory. The...
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DefinitionHepatic encephalopathy is a reversible neurologic syndrome that results from advanced liver dysfunction or portosystemic shunting. It leads to disturbances in cognition, behavior, and motor function due to the brain’s exposure to gut-derived toxins that the liver fails to detoxify.EtiologyThis condition develops either in the setting of acute fulminant hepatitis or progressively during chronic liver disease, such as cirrhosis and portal hypertension. Portosystemic...
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Diphtheria is an acute, toxin-mediated infectious disease that primarily affects the upper respiratory tract. It is caused by Corynebacterium diphtheriae, a Gram-positive, pleomorphic rod that lacks spore-forming capability and exhibits a characteristic club-shaped morphology under microscopic examination. While C. diphtheriae can asymptomatically colonize mucosal surfaces, clinical disease manifests only when the bacterial strain is lysogenized by a specific β-corynephage. This phage...
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Anti-NMDA Encephalitis in the Acute Setting.

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Anti-NMDA receptor encephalitis is a key cause of acute psychosis. Early suspicion and diagnosis by acute care physicians can prevent misdiagnosis and ensure timely treatment for patients.

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Area of Science:

  • Neurology
  • Immunology
  • Psychiatry

Background:

  • Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis is a significant cause of acute organic psychosis.
  • Misdiagnosis and delayed treatment are common due to presentation mimicking psychiatric disorders.
  • This review addresses diagnostic challenges in the acute care setting.

Purpose of the Study:

  • To review the pathophysiology and clinical presentation of anti-NMDA receptor encephalitis.
  • To propose a management pathway to expedite diagnosis and treatment.
  • To reduce misdiagnosis and inappropriate referrals to psychiatric services.

Main Methods:

  • Literature review of anti-NMDA receptor encephalitis.
  • Analysis of pathophysiology and presentation.
  • Development of a proposed management pathway.

Main Results:

  • Anti-NMDA receptor encephalitis presents with psychosis, often preceded by non-specific symptoms.
  • Routine CSF analysis may show pleocytosis and reduced protein, increasing suspicion.
  • Immunohistochemical testing is crucial for diagnosis, but its availability and efficiency are suboptimal.

Conclusions:

  • Acute care physicians should suspect anti-NMDA receptor encephalitis in acute psychosis cases after excluding infections.
  • CSF findings and immunohistochemical testing are vital diagnostic tools.
  • Improved diagnostic test availability and efficiency are needed for timely management.