Inflammation of the spinal cord: causes, description of symptoms, diagnosis and treatment methods. Inflammation of the brain: causes, symptoms. Methods for the treatment of inflammation of the lining of the brain Inflammation of the gray matter of the brain

Inflammation of the human brain is a rather serious and complex pathology, which, if not treated in time, can lead to the death of the patient.

Depending on the specific affected area, this condition can be of several varieties.

Let us consider in more detail the symptoms of inflammation of the cerebral cortex and the main methods of treating such an ailment.

Inflammation of the brain: causes

Inflammation of the brain can occur for the following reasons:

1. Meningitis is a disease in which the lining of the brain becomes inflamed. Its development can be provoked by various viruses, bacterial lesions (salmonella, staphylococcus, etc.), severe hypothermia or fungi.

According to their classification, meningitis can be serous or purulent.

According to the form of the course, the pathology is acute, subacute and chronic.

In addition to the main causes, the following diseases can cause acute meningitis:

Sinusitis, frontal sinusitis or sinusitis;

Inflammation of the lungs in severe degree;

Conjunctivitis;

Abscess (may be in different localization);

Furuncles;

Chicken pox (chickenpox usually leads to meningitis in adults, as it is more severe);

Mumps.

2. Encephalitis is a very severe pathology in which the patient's brain substance becomes inflamed. Based on statistics, encephalitis is characterized by a difficult course and high mortality rates.

Most often, this disease affects children (more than 75% of all cases).

Encephalitis can be primary and secondary. In the first case, severe viral infections (flu, mosquito and tick bites, herpes) can cause it.

Secondary encephalitis may occur due to complications from the following diseases:

Rubella;

The defeat of toxoplasmosis;

Malaria;

The development of complications after the introduction of the vaccine;

Inflammation of the cerebral cortex: symptoms and signs

Depending on the type and type of disease, inflammation of the brain can have the following symptoms:

1. Meningitis is accompanied by such manifestations:

Rapid increase in body temperature;

Increased blood pressure;

The appearance of a gray tint of the skin;

Feeling anxious;

Fear of bright light;

Intolerance to strong odors;

Very severe headache, which is localized in the area of ​​the temples and forehead;

Constantly recurring vomiting and nausea;

Intolerance to tactile touches;

Deterioration of muscle tone;

severe weakness;

excessive sweating;

An increase in heart rate.

With the rapid development of the disease, the above symptoms may develop within a day. Next comes swelling of the brain. In this state, the patient may suffer from confusion, convulsions and convulsions.

2. Encephalitis is usually accompanied by such manifestations:

Fever;

Anxiety;

Sleep disturbance;

Pain in the joints;

Very severe headaches;

swelling of the airways;

High body temperature;

Hallucinations and other mental disorders;

Hyperemia;

convulsions;

confusion;

Deterioration of general well-being;

The appearance of small bruises all over the body;

Violation of the heart rhythm.

Methods for the treatment of inflammation of the lining of the brain

When the first signs of inflammation of the brain appear, you should immediately call an ambulance. In this condition, the person is sent to the intensive care unit of the hospital.

The following procedures will help confirm the diagnosis:

1. Blood and urine tests.

4. The study of cerebral fluid will provide an opportunity to study the degree of the disease, to identify its form and cause.

The treatment of such inflammation is always selected for each patient on an individual basis, depending on the type of pathology, its cause and form of leakage.

Traditional therapy includes:

1. When the brain is damaged by bacteria, potent antibiotics are prescribed. You need to prick them within ten days. Types of antibiotics are selected depending on the causative agent of the disease.

2. When affected by viruses, treatment is carried out on the basis of symptoms (headaches, diarrhea and other symptoms are eliminated).

3. Diuretic drugs are used to relieve cerebral edema.

4. Albumin or isotonic solution can be used to reduce intoxication.

5. Glucocorticosteroids are used to prevent the progression of edema.

6. If the disease was caused by fungi, then antibiotics in this case will be ineffective. In this condition, the patient should be prescribed antimycotic drugs.

7. Antiviral drugs are prescribed for rapid viral damage. Usually, the drug Cytosinarabinosis is used for this purpose.

8. Gammaglobulin is the central and obligatory drug for inflammation of the brain. It has a pronounced therapeutic effect and must be administered intravenously for three days.

9. When convulsions or epileptic seizures are observed, anticonvulsants are used.

10. At high temperature and fever, antipyretic drugs are prescribed.

It's important to know, that meningitis and encephalitis are those categories of diseases that require careful monitoring in the treatment and reasonable selection of drugs. For this reason, self-medication when diagnosing such pathologies is categorically contraindicated.

Features of the treatment of inflammation of the lining of the brain

In addition to traditional drug therapy, the following procedures can be prescribed to a patient with inflammation of the brain:

1. Peloidetherapy or mud treatment. This procedure is aimed at stimulating the nervous system, producing hormones, enhancing carbohydrate metabolism and restoring lipid metabolism.

The duration of the procedure should be twenty minutes. The course of treatment includes twelve sessions.

2. Thalassotherapy or taking baths with the addition of beneficial chemicals (iodine, calcium, potassium, etc.). These trace elements will penetrate the skin through the sweat glands and enter the bloodstream. Thanks to this procedure, it is possible to improve microcirculation in tissues, restore brain dynamics and relieve inflammation.

The course of such treatment includes twenty sessions.

3. Treatment with mineral waters with trace elements (fluorine, copper, zinc). This therapy will help improve the metabolism in the body and reduce inflammation. The course of treatment is four weeks. You need to drink mineral water every morning on an empty stomach.

4. Medicinal electrophoresis is used to enhance the work of the cerebral cortex and activate the processes of homeostasis. The duration of the course is 15 procedures for twenty minutes.

In the absence of timely medical therapy, the patient may develop the following complications:

1. Paralysis.

2. Violation of vision.

3. Strabismus.

4. Violation of memory and hearing.

5. The appearance of epileptic seizures.

6. Development of acute or chronic renal and hepatic failure.

7. Violation of motor functions.

8. Deterioration of the heart.

The main complication of meningitis is considered fatal. It occurs if the patient is not treated within 5-8 days after the onset of the disease.

It is impossible to completely prevent inflammation of the brain, but you can reduce the risk of its development. To do this, follow the doctor's recommendations:

1. Give up bad habits (smoking, drinking alcohol).

2. Timely treat those diseases that can cause complications in the form of inflammation of the brain.

3. Get vaccinated against mumps, chickenpox and other diseases.

4. Avoid being in places where there are outbreaks of viral encephalitis.

5. Protect yourself from mosquito and tick bites. To do this, being in nature, it is important to wear tight trousers and outerwear. A hat must also be worn on the head.

In addition, to make it easier to notice ticks, clothing should be light-colored.

6. After returning from the forest or glades, you need to carefully examine your clothes, and the children who were with you. It is desirable to shake it and wash it well.

Also, do not forget about pets. Their fur can also hide dangerous insects that carry the disease.

Polioencephalitis (from the Greek polios-gray and encephalon - head M03rj, inflammation of the gray matter of the brain, i.e. a special case of encephalitis. The term was first introduced by Wernicke (Wernicke, 1881) to refer to a disease that is not essentially an inflammatory process; “acute hemorrhages Wernicke's polioencephalitis is apparently a vascular disease, but later this term was also applied to inflammatory diseases, and the upper acute P. was distinguished with the localization of the process in the gray matter of the legs of the brain (midbrain) from the lower acute P. with the localization of the process in the gray matter In 1884, Shtrumpel expressed the view that many cases of so-called infantile cerebral palsy are based on P., i.e., inflammation of the gray matter of the brain, while Shtrumpel drew an analogy between P. and poliomyelitis in the sense that P. is the result of localization in the cerebral cortex of the very process that, when localized in gray m substance of the spinal cord leads to a picture of acute anterior poliomyelitis. Subsequent observations fully confirmed the point of view expressed by Strümpel: during the epidemics of Heine-Medina b-ni, various forms of brain damage were observed along with spinal forms, and one of the main reasons for introducing the term "Heine-Medina b-n" was the fact that the term "acute poliomyelitis" used earlier contained idea of ​​only one kind (spinal) of this disease, a cut can be localized in any department of the central nervous system; and since Heine-Medina b-n can be observed not only epidemically, but also sporadically, then there is every reason to assert that at least some cases of P., i.e. cases of inflammation of the gray matter of the brain in the absence of any obvious infections are sporadic manifestations of Heine-Medina b-ni. However, there is no doubt that acute P. can be caused not only by the Heine-Medina virus b-ni, but also by other infections, among which the main place belongs to scarlet fever, measles, typhus, influenza. It is impossible not to admit that P.'s term contains a certain inaccuracy: by its very nature, the inflammatory process, representing a diffuse rather than a systemic lesion, cannot be strictly limited to one gray matter; almost always in diseases referred to by the term "polioencephalitis", there is b. or m. clear involvement in the process and white matter. This amendment is quite appropriate in relation to Wernicke's b-ni (osary upper hemorrhagic P., polioencephalitis haemorragica superior), with a cut also hemorrhages are not limited to the gray matter of the midbrain (see below). Isolated lesions of the gray matter are observed not in inflammatory processes, but in primary systemic degenerations. Yek-rye authors applied the term "polioencephalitis" to this kind of diseases, designating them as "chronic P.". So, van Gehuchten (van Gehuchten) and others designate the term "chronic upper P." hron. progressive ophthalmoplegia, and the term "chronic lower P." - progressive bulbar paralysis. Such an application of the term "polioencephalitis", which includes the idea of ​​an inflammatory process, to diseases that obviously do not have the character of an inflammation, hardly deserves to be imitated. The application of the term "polioencephalitis" to the progressive degeneration of the nuclei of the brain stem and nuclei of the medulla oblongata should also be recognized as inappropriate. If we proceed from the analogy with poliomyelitis, then of course we can talk about acute and hron. P. So the term "polioencephalitis" would be advisable to keep only for acute inflammatory lesions of the brain, with the caveat that in most of these cases, contrary to the exact meaning of the word P., it is a matter of predominant, and not exclusive, damage to the gray matter. In this sense, epidemic or lethargic encephalitis could also be attributed to P.'s group (see. encephalitis), at to-rykh also pat.-anatomical observations indicate a predominant lesion of the gray matter (nuclei pro - I of the interstitial and midbrain); but this disease is allocated, as is known, in an independent nosological form and the term "polioencephalitis" is not indicated. So. image. the term "polioencephalitis" is used in present. time firstly to acute inflammatory processes with pr

Scientists of antiquity must have encountered such a severe pathology as encephalitis, but since medical knowledge was just emerging, there were no accurate diagnostic methods, and there were no ideas about microorganisms at all, inflammatory processes in the brain, often accompanied by an increase in body temperature, were simply attributed to fevers, changes consciousness in which no one is surprised to this day.

With the development of medical science, enough evidence has been accumulated that inflammation is possible not only in tissues visible to the eye, but also in internal organs, and the brain is no exception. Neurological symptoms against the background of clear signs of intoxication and fever make it possible to suspect encephalitis already when examining the patient, although the exact cause of the disease can not always be established.

The causes and forms of brain inflammation are quite diverse, but a special place is occupied by tick-borne encephalitis, which is a dangerous independent disease, often leading to a tragic outcome. We will pay special attention to tick-borne encephalitis a little lower.

Despite all the variety of causes and types of encephalitis, its manifestations are rather stereotypical in severe cases of the disease, but if inflammation of the nervous tissue accompanies other ailments, then it is not so easy to recognize encephalitis as such. It happens, for example, that a change in consciousness, headache, vomiting and other signs of trouble in the brain are attributed to intoxication, fever, dehydration. By and large, if encephalitis is secondary to other serious diseases and develops as their complication, then the patient is already receiving a fairly wide range of drugs by that time, and the hospital has the opportunity to quickly conduct appropriate studies. This cannot be said about a special form of brain damage - tick-borne encephalitis. A tick bite does not make everyone want to examine it for infection, and then the disease can be taken by surprise.

Inflammation of the brain tissue is a difficult process, dooming death at worst, at best - to gross changes in the activity of the nervous system and natural disability. A relatively favorable outcome with encephalitis, although it happens, is quite rare, so any suspicious symptoms regarding brain damage should not go unnoticed by the doctor.

Types and causes of inflammation in the brain

Depending on the cause, there are:

1. Encephalitis of infectious origin (viral, bacterial, fungal).
2. Toxic encephalitis in case of poisoning with various poisons.
3. Autoimmune encephalitis.
4. Post-vaccination.

In most cases, encephalitis is caused by viruses or bacteria that enter the brain. with blood or lymph flow. Some microorganisms immediately choose the nervous tissue as the most favorable habitat for themselves (neurotropic viruses), while others get there during a severe course of an infectious disease of another localization.

With influenza, measles, HIV infection, rubella or chickenpox, brain damage is secondary and is characteristic of severe forms of these diseases, while rabies, herpes, tick-borne encephalitis viruses initially choose nervous tissue for their life activity, without affecting other organs. . Most neurotropic viruses tend to cause epidemic outbreaks of the disease with clear seasonality and geographical features. In hot countries with an abundance of blood-sucking insects, in the taiga, where tick activity is very high, outbreaks of encephalitis are recorded quite often, so the alertness among medical workers in these regions is extremely high during periods of maximum risk of infection, and the population is informed about the possible consequences of the disease and is actively vaccinated.

map of the predominant distribution of viral tick-borne encephalitis

Bacterial encephalitis is somewhat less common, can occur with purulent inflammation and involvement in the process of the pia mater (meningoencephalitis).

The main route of infection to the brain is considered to be hematogenous (with blood flow), when, after a mosquito or tick bite, viruses enter the bloodstream and are sent to the nervous tissue. It is also possible that the contact-household transmission route, airborne (herpes), alimentary when the infection enters through the gastrointestinal tract (enteroviruses).

However, microbes are not always the cause of brain damage. In some cases, encephalitis develops against the background of the toxic effects of various poisons (heavy metals, carbon monoxide), an autoimmune process, and an allergic reaction.

Frequent vaccinations, non-compliance with the terms indicated in the vaccination schedule, can also cause inflammation of the brain substance. The most dangerous in this respect are DTP vaccines, against smallpox and rabies, which may contain live microorganisms and, under certain conditions, cause complications in the form of brain damage.

Often it is not possible to establish the exact cause of the disease, so the localization, prevalence and course of encephalitis are also taken into account. If the inflammatory process began initially in the brain, and the changes are limited to the nervous tissue, then encephalitis will be called primary. In this case, most often the culprit will be a neurotropic virus. O secondary encephalitis they say when there are prerequisites for the subsequent involvement of the brain in the pathological process in other diseases: severe measles or influenza, immunity disorders, malignant tumors, an autoimmune process, HIV infection, etc. The selection of these forms is also reflected in the subsequent treatment tactics patient.

The inflammatory process may affect predominantly the white matter of the brain ( leukoencephalitis), or gray (bark), then they talk about polioencephalitis. Inflammation of both white and gray matter, along with nerve pathways, is the most severe form of brain damage - panencephalitis. In some cases, not only the substance of the brain is involved, but also its membranes, in particular, the vascular one, this condition is called meningoencephalitis.

What happens with encephalitis?

Changes in the nervous tissue in encephalitis are rather stereotypical, and only in some cases can signs of a specific disease be detected (rabies, for example). The significance for the body and the consequences of any inflammatory changes in the brain are always serious, so you should not once again remind them of their danger.

Edema, hemorrhages, accumulations of inflammatory blood cells (leukocytes), destruction of the membranes and the processes of neurons themselves lead to irreversible changes, and the low ability of the nervous tissue to regenerate does not give patients a chance for a favorable outcome and restoration of lost functions.

The structures of the subcortical nuclei, white matter, medulla oblongata and stem are often damaged, therefore, the manifestations are not limited to cerebral symptoms, and indispensable companions of such encephalitis will be paralysis, respiratory failure, functions of the cardiovascular system, etc.

In addition to damage to nerve cells, the patient's condition is aggravated by increasing cerebral edema, which certainly accompanies any inflammation, regardless of its nature and location. Enlarged, the edematous brain does not fit well in the cranium, rises, and the patient's condition progressively worsens. Along with damage to vital nerve centers, swelling can be fatal in encephalitis.

With a bacterial infection, inflammation often becomes purulent, spreading to the pia mater. In such cases, in addition to foci of purulent fusion in the brain tissue, a kind of "cap" or, as they also call it, a "purulent cap" is formed, enveloping the already suffering brain. This condition is very, very dangerous, and delaying medical care can cost lives.

Manifestations of encephalitis

Signs of encephalitis are determined by the cause, localization of the focus of inflammation, the course of the disease, but in most cases, against the background of focal neurological changes, they are expressed and common symptoms of brain damage. These include:

• , often intense, all over the head, without a clear localization.
• Nausea and vomiting, which does not bring relief, which makes it possible to exclude the pathology of the gastrointestinal tract in favor of the brain.
• Impaired consciousness - from mild drowsiness to coma with loss of response to external stimuli.
• Fever, at which the temperature, as a rule, exceeds the threshold of 38 degrees and is difficult to reduce, since it is associated with damage to the corresponding structures of the brain.

Focal symptoms of encephalitis are predetermined by the part of the brain in which pathological changes are most pronounced. Thus, patients may lose the ability to coordinate movements when the cerebellum is involved, vision is impaired when the occipital lobe is affected, pronounced changes in the intellectual sphere and behavioral reactions are accompanied by inflammation in the frontal lobes.

Encephalitis can occur in the form of the so-called abortive form, when the symptoms of brain damage are limited to moderate pain in the head and stiff neck. In the presence of such symptoms, fever, signs of a respiratory or gastrointestinal infection, it is necessary to examine the cerebrospinal fluid to rule out brain pathology.

Tick-borne encephalitis

Having set out to learn a little more about inflammatory processes in the brain, it is easy to see that most of the information on this problem is devoted to tick-borne encephalitis. This is not surprising, because tick-borne encephalitis, being an independent disease, affects absolutely healthy people of any age and gender, and the seasonality and mass nature of infection with the infectious agent make it necessary to navigate the essence of the disease not only for health workers, but also for people at risk.

The danger of tick-borne encephalitis lies in the fact that in almost all cases it leaves behind persistent neurological disorders that not only limit the subsequent life of the sick person, but also capable of chaining him to bed forever. In children, the disease is more severe than in adults, and residual effects and dangerous consequences can radically change the life of a small person, far from for the better.

A bit of history

The first published descriptions of a seasonal disease that occurs with damage to the nervous system appeared at the end of the 19th century. In the first third of the last century, large-scale scientific research has already been carried out, which has borne fruit: the pathogen (virus) was isolated, the carrier (tick) was identified, the clinical picture of the disease was described in detail, approaches to treatment and, very importantly, preventive measures were developed.

However, the study of tick-borne encephalitis, like any other infectious disease, did not pass without tragic episodes, when the selfless work of scientists led to their death.

The development of Siberia and the Far East in the 30s of the last century, the development of industry and the strengthening of the border required an influx of qualified personnel into these regions, and along with the construction of numerous correctional institutions, led to the resettlement of a huge number of people for whom the climate and natural features of the area turned out to be alien. It was then that the attention of A. G. Panov was attracted by mass outbreaks of a seasonal disease with damage to the central nervous system. Already in 1937, an expedition was organized under the leadership of Professor L. A. Zilber, whose members came to grips with the study of the nature of encephalitis.

dog and taiga tick - both can be carriers of encephalitis

Thanks to the efforts of virologists, infectious disease specialists, with the active help of Khabarovsk neurologists, who knew firsthand about a dangerous disease, the causative agent of the infection was identified, which turned out to be a virus, as well as the most likely carrier - the ixodid tick, whose favorite habitat is considered to be taiga regions.

The disease spared no one. Most of those who were bitten by the tick developed encephalitis, and the risk of death remained and remains quite high. Among the victims of the insidious infection, there are many scientists, employees of virological laboratories, doctors who conducted research in the field. So, one of the discoverers of the viral nature of tick-borne encephalitis, MP Chumakov, contracted the infection during the autopsy of a deceased patient. The acute form of the disease was replaced by a chronic one and pursued the scientist until the end of his life. Without looking at hearing impairment and movement disorders, Academician Chumakov continued to work actively for many years, and bequeathed his body to study the chronic form of encephalitis, which had been occurring for decades. One of the entomologists, B. I. Pomerantsev, who was searching for the carrier of the infection, died after a tick bite from a severe form of encephalitis.

Not without politics. Shortly after the start of the expedition, in the midst of research work, its leader, Professor Zilber, and two other employees were arrested, who were suspected of spreading Japanese encephalitis in the region, but the accusation was false, and 1937 was marked by the discovery of the tick-borne encephalitis virus thanks to selfless Russian scientists.

Where does the infection come from?

As noted above, tick-borne encephalitis is common in the forest and forest-steppe zones of Siberia, the Urals, the Far East, and is found in many countries of the central and western parts of the Eurasian continent (France, Germany, Poland, Belarus, the Baltic region). Cases of tick-borne encephalitis are also recorded in Mongolia and the wooded part of China. Every year, in Russia alone, more than half a million people seek medical help after a tick bite, including children. The infection is especially severe in residents of the Far East, where the frequency of severe complications and deaths is especially high.

the prevalence of encephalitis in the regions of Russia (incidence per 100,000 people)

In nature, the tick-borne encephalitis virus is found in animals and birds - rodents, wolves, elks, cattle, which serve as a source of food for ticks, infecting them at the same time. A person among them happens to be by chance, but for a tick it does not matter whose blood it will feed on and to whom it will transmit the virus.

There is a pronounced seasonality of the disease, the peak of which falls on the spring-summer period. The culprits of this are also ixodid ticks, which, after a long winter hibernation, crawl out to the surface and begin to hunt. Ticks hunt in the literal sense, that is, they wait for the victim and attack.

Hungry ticks prefer to wait for prey in shady bushes or grass, crawling out of the forest floor and spreading up to a height of one and a half meters. This happens when you visit the forest, but you need to remember that the tick itself can “come” into the house: with flowers, branches, clothes, pets, so even a family member who avoids forest walks can suffer.

Due to the ability to feel changes in the concentration of carbon dioxide in the environment and thermal radiation, the tick accurately determines the approach of a food source and attacks. Lacking the ability to jump or fly, it clings to or falls on its prey. On the human body, the tick always crawls up, reaching the thin and delicate skin of the neck, abdomen, chest, and axillary zones. Since the saliva of insects contains substances with anticoagulant and anesthetic properties, the bite may not be immediately noticeable, so brushing it off like a mosquito or midge will not work. Moreover, if females stick for a long period of time, then males do it quickly, so the very fact of a tick bite can go unnoticed, then the cause of the malaise and the subsequent development of the disease can not be established immediately. The female can remain on the human body for many days, and only after being saturated with blood and having increased in weight by several tens, or even a hundred times, she leaves the victim.

The risk group for viral tick-borne encephalitis includes foresters and other workers whose activities are associated with visiting forests, geologists, road builders, tourists, avid fans of picking mushrooms and berries, or just walking and having picnics in nature. In areas endemic for encephalitis, this may not be safe.

You can get infected with tick-borne encephalitis not only in the forest, but also in city parks and squares, in gardens and summer cottages. It is worth remembering this when intending to take a walk in the shade of trees, even within the city limits.

In addition to the transmissible route of transmission of the infection (through an insect bite), cases of infection have been described when drinking raw goat or cow's milk. This happens in children who are given raw milk from private farms. Boiling destroys the encephalitis virus, so do not neglect such a simple procedure, especially when it comes to the smallest.

Features of the course of tick-borne encephalitis

The tick-borne encephalitis virus, once in the bloodstream, is sent to the nervous tissue, affecting the cerebral cortex, white matter, subcortical nuclei, cranial nerves, spinal roots, causing paresis and paralysis, and a change in sensitivity. Involvement of various brain structures can cause seizures, impaired consciousness up to coma, cerebral edema. The older the patient, the higher the risk of complications and severe course of the disease, and after 60 years the probability of death is especially high.

Like any other infection, tick-borne encephalitis occurs with a latent period, during which there may be no signs of the disease at all.

Average the incubation period lasts 1-2 weeks, maximum - 30 days, when the infectious agent multiplies intensively already in the human body. By the end of the latent course, weakness, weakness, body aches, fever may appear, that is, symptoms characteristic of many infectious diseases, therefore it is so important to establish the fact of a tick bite, because it is not so easy to suspect encephalitis in such cases.

Depending on the predominance of one or another symptom of the disease, tick current forms encephalitis:

1. Feverish.
2. Meningeal.
3. With focal lesions of the nervous tissue.
4. Chronic variants of the course.

The first three forms are classified as acute encephalitis, and the febrile and meningeal varieties account for about 90% of all cases of the disease. Chronic tick-borne encephalitis is diagnosed much less often, which can last for years, continuously progressing and leading to persistent neurological disorders.

Without focusing on a detailed description of the various symptoms of damage to the nervous system, it is worth pointing out development in patients of three main syndromes:

1. General infectious nature.
2. Meningeal.
3. Syndrome of focal pathology of the nervous system.

manifestations of encephalitis

Signs of a general infectious nature are associated with increased reproduction of the virus and its spread not only to the nervous tissue, but also to other parenchymal organs, as well as to the effect on the walls of blood vessels. Patients develop a severe fever with a rise in temperature to 39-40 degrees, chills, weakness, muscle and bone pain, and dyspeptic disorders are possible.

meningeal syndrome associated with damage to the pia mater and increased intracranial pressure. It includes a severe headache, nausea, repeated vomiting that does not bring relief, impaired consciousness, photophobia, convulsions, psychomotor agitation.

Syndrome of focal neurological disorders associated with damage to specific parts of the nervous system and is manifested by paralysis, paresis, impaired sensitivity and function of the cardiovascular, respiratory system, convulsive syndrome.

Feverish form disease is characterized by a favorable prognosis and rapid recovery. This is the mildest form of tick-borne encephalitis, occurring with little or no damage to the nervous tissue by the virus. Symptoms are reduced to fever, common signs of an infectious process (nausea, weakness, headache). Fever and flu-like changes last for about three to five days, after which recovery begins.

meningeal variant The course of encephalitis is considered the most frequent, and the manifestations are headache, soreness in the eyes, nausea and vomiting. In addition to the characteristic symptoms, changes in the cerebrospinal fluid can also be detected. Signs of damage to the meninges in the form of stiff neck muscles and other meningeal symptoms can easily be determined by a health worker of any specialty, so diagnosing this form of the disease after a tick bite does not cause great difficulties. The fever lasts about one to two weeks, and then recovery occurs. The meningeal form is considered favorable, although the consequences in the form of headaches can accompany the patient for quite some time.

A form of tick-borne encephalitis with focal neurological disorders the rarest and, at the same time, the most severe in terms of course and consequences. Mortality with it reaches 40% with the Far Eastern type of infection. With simultaneous damage to the meninges and brain matter (meningoencephalitis), the course of the disease is very severe: fever, nausea and vomiting, headache, convulsions up to epistatus, impaired consciousness in the form of delirium, hallucinations, coma. The recovery process is delayed up to 2 years or more, and the consequences in the form of paralysis and muscle atrophy persist for life.

In addition to the cerebral hemispheres, damage to the brain stem, spinal roots and peripheral nerves is possible. These cases are accompanied by persistent paralysis, severe pain, and inevitably lead to serious disorders that turn a previously healthy person into an invalid, bedridden, unable to move or even speak. Such patients remain profoundly disabled, who need constant care and supervision, since even eating becomes a problem.

In children, the disease is severe and more often recorded in boys of primary school age. The forms of the course of infection are similar to those described for adults. Symptoms of brain damage develop rapidly and leave consequences in the form of paralysis, etc. In children, more often than in adults, complications are observed in the form of convulsive syndrome and hyperkinesis - involuntary excessive movements of the limbs, head, torso, sometimes persisting for life. Since a child often does not know about the danger of tick bites, and even more so, does not carefully examine the skin after walking in a forest or park, the task of preventing and timely detection of blood-sucking insects lies with the parents.

Video: consequences of tick-borne encephalitis

Identification and treatment of tick-borne encephalitis

Diagnosis of encephalitis is based on a characteristic clinical picture, data on visiting forests, and the presence of a tick bite. Used to confirm the diagnosis laboratory methods, allowing to detect specific antibodies (proteins) produced in the patient's body in response to the introduction of the virus. When contacting a doctor, the first thing the patient will be offered is to donate blood, in which elevated leukocytes, accelerated ESR can be detected, but these changes are nonspecific and accompany many other diseases, so it is so important to conduct serological studies to search for antibodies.

Equally important is analysisliquor, in which the content of lymphocytes and protein increases, and its leakage under pressure indicates intracranial hypertension. It should be noted that it is not always possible to examine the cerebrospinal fluid. For example, in coma and dysfunction of the medulla oblongata, this manipulation is contraindicated, and doctors are forced to wait for the patient's condition to stabilize. At the same time, with a relatively mild febrile form of the disease, there are no changes in the cerebrospinal fluid, and the diagnosis is based on the search for antiviral antibodies.

Can bring invaluable benefits tick analysis for the presence of tick-borne encephalitis virus in it, therefore it is so important not only to remove it when it is found on the body, but also to save it and transfer it to the appropriate laboratory. If the concerns about tick infection are confirmed, then it is possible to prevent the disease in advance and start treatment as early as possible.

Treatment of tick-borne encephalitis requires mandatory hospitalization in the intensive care unit. Patients are shown strict bed rest with minimizing all kinds of irritants. Rational nutrition plays an important role, especially since the infection is often accompanied by dysfunction of the digestive organs.

Therapy prescribed includes:

Video: what to do after suffering encephalitis?

Prevention of tick-borne encephalitis

The rule "disease is easier to prevent than to cure" works very well for tick-borne infections, and therefore preventive measures are of paramount importance in the foci of the spread of the disease.

Prevention of tick-borne encephalitis includes non-specific measures that are desirable to observe and know for those who live in dangerous areas and visit tick habitats. Specific prevention consists in the use of vaccines according to the developed schemes.

When visiting forests and other habitats of ticks, you need to follow simple rules:

1. Clothing should be as closed as possible, overalls are preferred, a scarf or cap is required, and it is better to protect the neck and head with a hood. Collar, sleeve cuffs, socks should fit snugly against the surface of the skin. If possible, you should wear light-colored and plain clothes so that in the event of a tick attack, it is easier to notice. At home, clothes should be shaken out and it is advisable to leave them away from living quarters;
2. It is useful to examine the skin as often as possible, not only to yourself, but also to ask others, because the scalp, back, back of the neck is quite problematic to carefully examine even with a mirror;
3. Plants and other items brought from the forest may well become a source of ticks for all family members, so it is better to avoid such "souvenirs". Pets should also be examined, because they can become a victim of "bloodsuckers";
4. If you need to spend the night in the forest, it is better to choose places without grass, open areas with sandy soil to minimize the likelihood of tick attacks;
5. The use of repellents applied to the skin, as well as acaricides for treating clothes, helps protect against insects, so this method of prevention should not be neglected. Children should be treated by adults, and when walking with babies, their tendency to put their fingers in their mouths should be taken into account, so it is better to leave the hands untreated.

If the tick nevertheless attacked, then you need to remove it correctly or contact a medical facility(trauma center, ambulance station). At home, to extract the “bloodsucker”, the bite site should be lubricated with vegetable oil, and the tick should be captured with tweezers or a thread, tied around the neck, while making swinging movements, as if twisting the insect out of the skin. It happens that when you try to remove a tick, its body comes off, and the head remains in the skin. In such cases, it is necessary to immediately contact a specialist, since the risk of infection remains.

infographic: Belta

Specific prevention of tick-borne encephalitis consists in vaccinating the population of areas endemic for the disease, as well as visitors. Among local residents, the proportion of those vaccinated should not be less than 95%, and special attention is paid to persons whose professional activities are related to staying in tick habitats.

The standard of vaccination is the introduction of the drug twice, followed by revaccination once a year. The effect will be if the vaccination is carried out at least two weeks before leaving for the endemic focus or before the start of the epidemic season. Vaccination against tick-borne encephalitis can be done both urgently in case of tick bite, and planned according to the standard scheme, which implies at least one revaccination. Emergency prophylaxis is carried out on the first day after an insect bite.

In addition to tick-borne encephalitis, there are, although much less frequently, secondary inflammatory processes in the brain that complicate the course of other diseases - tumors of the hematopoietic system, sepsis, measles and chickenpox, traumatic injuries. Approaches to therapy in such conditions are determined by the nature of the underlying disease and the symptoms of brain damage.

In case of tick-borne infections, vigilance and caution when visiting the habitats of blood-sucking insects, timely detection and removal of the tick, vaccination and early contact with specialists can significantly reduce the risk of infection, as well as improve the results of therapy in the development of encephalitis.

Video: encephalitis in the program “Live Healthy!”

One of the presenters will answer your question.

At the moment, answers questions: A. Olesya Valerievna, candidate of medical sciences, teacher of a medical university

Any spinal inflammatory process, or inflammation of the spinal cord, is called myelitis. In patients, both gray and white medulla can be affected. Such a disease cannot be classified as common: it is diagnosed only in 5 people per 1 million population. Despite this, myelitis is difficult to treat, and the risk of developing serious complications is quite high.

It is difficult to determine the signs of those groups of people who can get myelitis. It is definitely impossible to determine the gender or age category of potential patients. However, a number of researchers, having studied the statistics, argue that most often the pathology is observed in a fairly young (from 10 to 20 years) and old age.

Causes and classification

Depending on the order of occurrence of inflammation, the causes of myelitis fall into one of 2 categories:

• Primary - as a result of a direct negative impact (infection, spinal injury);
• Secondary - when myelitis becomes a consequence of a complication of any pathology or appears against its background (repeated infection).

The infection enters the body through the circulatory system or an open wound. In this case, viruses of the neurotropic group (varicella, lichen, polio, herpes, mumps, influenza, measles, rabies, tetanus, etc.) are likely pathogens.

The classification of this neurological disease, based on the method of occurrence, is as follows:

• intoxication origin;
• infectious;
• Post-traumatic;
• Unexplained etiology (idiopathic).

There are also cases when myelitis is caused by metabolic disorders: pernicious anemia, diabetes mellitus, chronic liver diseases.

Development of the disease

Any of the factors (trauma, infection), which is the cause of myelitis, causes not only inflammation, but also swelling of the spinal cord - this is the mechanism that triggers the development of the pathological process. Due to edema in adjacent tissues, blood supply is disrupted with the formation of blood clots in the vessels. This condition further increases the swelling. From this we can conclude that inflammation of the spinal cord, like many other neurological diseases, develops cyclically.

The deterioration of blood circulation, as well as its absence in certain areas, leads to softening and death of nerve cells and tissues. The morphological structure of the affected area looks flabby and edematous, the “butterfly” shape characteristic of the spinal cord is blurred. When examining the focus of necrosis under a microscope, such characteristic signs as the breakdown of myelin, severe swelling, the process of infiltration, areas of hemorrhage are visible.

After recovery, instead of dead sections of nerve fibers, a scar is formed, formed from connective tissue. Of course, due to the peculiarities of the structure, the scar cannot function as accumulations of cells, therefore, the disorders that appeared during the period of the disease remain even after the patient has been cured.

Symptoms

The clinical manifestations of myelitis are different, their severity depends on the level and degree. The main ones are:

• Unpleasant pain sensations;
• Violation of sensitivity;
• Paralysis;
• Pelvic dysfunction, etc.

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The first signs are similar to the symptoms of any infectious process: chills, general weakness and fever up to 39 degrees. The presence of a neurological disease is signaled by back pain, which can spread from the affected area to neighboring tissues.

Severe myelitis results in loss of both motor and sensory function of the spinal cord.

Diagnostics

Measures to identify myelitis involve a consultation with a neurologist. After questioning the patient and visual examination, the specialist prescribes a study of the cerebrospinal fluid, which is taken by lumbar puncture - this is a traumatic, but highly accurate method for determining the pathology. As a rule, this is enough for an objective diagnosis.

For reinsurance, an additional study of the cerebrospinal fluid may be performed. So, the differentiation of myelitis from pathologies similar in the clinic (circulatory disorders of the spinal cord, hematomyelia, tumors of various etiologies, Guillain-Barré syndrome and) is carried out after analyzing the cerebrospinal fluid puncture. Often, in order to diagnose acute myelitis, myelography and tomography (MRI or CT) of the spinal column are prescribed.

Myelitis treatment

The choice of a therapeutic complex depends on the etiology of myelitis, the symptoms of the disease in a particular case, the features of the development of the pathology and the general condition of the patient. Among the measures for the treatment of myelitis are considered effective:

• Prescribing medications (quite large doses of broad-spectrum antibiotics, uroseptics, analgesics, antipyretics, muscle relaxants, anti-inflammatory drugs - mainly glucocorticoids);
• A set of exercise therapy exercises;
• Physiotherapeutic methods of treatment (mainly UVI).

In case of violations of the functions of urination, catheterization and washing of the bladder are carried out, drugs of the anticholinesterase group are prescribed. To restore the functioning of nerve cells after the treatment, vitamin therapy is used and vitamins of group B are taken, it is recommended in the form of a solution for injection.

You can prevent the appearance of bedsores as follows: you can put a special circle or cotton swabs under the bone protrusions, periodically help the patient change the position of the body, rub the skin with a solution of soap with alcohol or camphor. In addition, UVI is used on the ankle, sacrum and buttocks.

Advanced stages lead to death (inflammation in the cervical region), or to disability (thoracic and lumbar myelitis) of the patient. Therefore, it is important to undergo an examination and immediately begin therapy.

If the pathology proceeds favorably, and the treatment is carried out correctly, the patient's recovery occurs after a maximum of three months, and after a year or two the patient is fully restored. Timely appointed and adequate sanitary-resort treatment can accelerate these processes at times.

Inflammation of the spinal cord, or myelitis, is a serious disease that has serious consequences for life. Only timely detection of the disease and proper treatment allows you to get rid of all the symptoms and manifestations. The inflammatory process develops rapidly. It is extremely important to exclude self-medication and immediately contact experienced doctors.

Symptoms of myelitis appear on the rise. The patient's condition worsens every second. Among the main manifestations are the following:

• a sharp increase in body temperature;
• severe chills, dizziness;
• muscle weakness;
• back pain.

In the first days of the disease, symptoms characteristic of many diseases appear, then characteristic meningeal symptoms appear, but only a doctor can identify them and draw the right conclusions.

There are many varieties of myelitis, depending on the localization of the inflammatory process, the degree of damage to the spinal membranes. Each type of disease has its own symptoms. Back pain can occur in different areas and departments. The stage of development of the disease is also of no small importance. If at the initial stage the patient has a very bad back pain, he cannot tear his head and neck from a prone position, then after a couple of days there is paralysis of the limbs, incontinence of feces and urine.

A significant increase in the patient's body temperature is an important sign. If the temperature does not go down well, you should immediately consult a doctor. No need to wait for other symptoms to appear, let specialists quickly make a correct diagnosis.

Reasons for the development of the disease

Myelitis can be primary or secondary. In the first case, the gray and white matter of the spinal cord is initially affected. In the second case, inflammation is a consequence of other ailments. Myelitis is often caused by viruses and bacteria. Cancer patients are characterized by the so-called radiation myelitis, which develops against the background of radiation therapy. It manifests itself 6-12 months after the end of the treatment of the underlying disease. Often, both patients and attending physicians are ready for such an outcome, so the treatment of the inflammatory process begins in a timely manner, the therapy gives a positive result.

Severe hypothermia is another cause of myelitis. It is impossible to "cold" the spinal cord, but under the influence of low temperatures, the body's immune response decreases, so viruses and bacteria quickly penetrate into the membranes of the spinal cord and actively multiply there.

Diagnosis of inflammation of the spinal cord

Inflammation of the spinal cord is diagnosed in a hospital setting. First, the doctor examines the patient, collects an anamnesis. General biochemical blood tests are prescribed. Elevated leukocytes, increased ESR - these are characteristic indicators in the acute period of the disease. An accurate diagnosis can only be made after a spinal cord puncture. Examination of the cerebrospinal fluid allows not only to identify inflammation, but also its pathogens. It is determined which microorganisms are present in the fluid from the spinal cord, their sensitivity to antibiotics is checked in order to select drugs that will be effective in the treatment process.

The doctor makes certain conclusions about the alleged diagnosis already during the puncture for the puncture. This procedure is specifically performed without additional anesthesia in order to assess the patient's response. If he does not feel pain and the slightest discomfort during the puncture, we can talk about myelitis.

Types of disease

The classification of myelitis is extensive. To a greater extent, doctors need this knowledge in order to correctly diagnose the inflammatory process in the spinal cord and determine the correct treatment tactics. According to the duration of the course, acute, subacute and chronic myelitis are distinguished. The degree of damage to the spinal cord matters. Inflammation can be limited, widespread, focal. Separately isolated transverse myelitis. In this case, the inflammatory process develops in several adjacent areas.

Of no small importance is the cause of the development of myelitis. Inflammation occurs under the influence of viruses, bacteria, ionizing radiation, trauma, strong toxins. In rare cases, it is not possible to establish the cause of the development of the inflammatory process. Then myelitis is more difficult to treat.

Features of treatment

Treatment of myelitis is always carried out in a hospital setting. This problem is dealt with by a neurologist. It determines the localization of inflammation, the degree of damage to the white and gray matter of the spinal cord. The inflammatory process must be stopped. At the same time, there is a struggle with the symptoms of myelitis.

Hormonal painkillers and anti-inflammatory drugs are immediately prescribed. In our country, drugs based on prednisolone are actively used. They are effective in the treatment of myelitis. These drugs enter the body in the maximum allowable doses.

A patient with myelitis must be prescribed broad-spectrum antibiotics, also in the maximum allowable doses. These drugs must be taken even if a virus has become the cause of the development of inflammation of the spinal cord. Such actions are aimed at reducing the likelihood of developing serious negative consequences of myelitis.

Be sure to take diuretics to avoid tissues. Often, in the treatment of myelitis, the patient is already paralyzed, so additional measures are taken to avoid bedsores.

When the main danger has passed, myelitis is eliminated, the stage of recovery and rehabilitation begins. If the correct diagnosis was made in a timely manner, and the doctor immediately began treatment, the patient has a good chance to return to normal life, although some manifestations of the disease will remain with him forever.

Rehabilitation of patients after treatment

Myelitis is a serious disease that affects the bone marrow. Everyone knows that this organ is responsible for human immunity, because it is here that the production of leukocytes is carried out. Although modern medical technologies make it possible to treat myelitis, it is possible to completely get rid of the consequences of inflammation of the spinal cord only in a few cases.

Restoration of all functions and systems of the body is carried out within 1-2 years after the completion of the treatment of inflammation of the spinal cord. During this period, the patient is engaged in exercise therapy, undergoes courses of reflexology. The final prognosis largely depends on the location of inflammation, the degree of tissue damage. Patients are often given a disability group, but many return to normal life and even to work.