Meningoencephalitis - causes, symptoms and treatment. How dangerous is meningoencephalitis and how is it treated? Meningoencephalitis with a chronic long-term course

is an inflammation of the membranes of the brain.
If these two processes are observed simultaneously, they speak of meningoencephalitis.

Causes of meningoencephalitis

Encephalitis is a polyetiological disease, it can be infectious, infectious-allergic, toxic.

• Primary encephalitis - viral - arbovirus, tick-borne, mosquito, enterovirus, herpetic, influenza, with rabies, epidemic; microbial and rickettsial - with neurosyphilis, typhus.
• Secondary encephalitis - with measles, rubella, chicken pox, post-vaccination, microbial - staphylococcal, meningococcal, streptococcal, tuberculosis, malaria, toxoplasma.
• Encephalitis can be caused by a demyelinating process.
• Acute mumps meningoencephalitis.
• Inflammatory diseases of the paranasal sinuses can be complicated by meningoencephalitis.

- a serious disease of the brain and meninges. May be a complication of encephalitis and meningitis. In any case, such a complication is a serious pathology, aggravates the course of the disease, has a poor prognosis with a possible fatal outcome, residual neurological deficit. The severity of residual effects depends on the degree of damage to the central nervous system.

Symptoms of meningoencephalitis

Meningoencephalitis may be manifestation of a general septic process. The patient's condition worsens, there is a high temperature, intense headache, impaired consciousness - lethargy, agitation, delirium, stupor, vomiting, convulsions are possible (more often in childhood). Meningeal signs appear - Kernig, Brudzinsky, stiff neck, photophobia, hyperesthesia. Meningeal symptoms are accompanied by symptoms of brain damage - damage to the cranial nerves, anisoreflexia, hemiparesis, impaired coordination, disorders of higher nervous activity - mental deviations, aphatic disorders, apraxia, alexia, ... depending on the affected area - frontal, temporal, parietal, occipital, more often cortical departments. Meningoencephalitis can be complicated by abscess formation of the brain, cerebellum.

Severely leaking influenza hemorrhagic meningoencephalitis. High temperature, chills, impaired consciousness up to coma, often epileptic seizures. A variety of focal symptoms of brain damage are added to meningeal symptoms. It is a complication of the flu.

Herpetic meningoencephalitis may be serous or hemorrhagic. It is a complication of herpetic infection.

Dual wave viral meningoencephalitis- caused by one of the strains of the filterable tick-borne encephalitis virus. You can become infected through the milk of sick animals, the carriers of the disease are ixodid ticks. There is a spring-summer seasonality. The onset is acute, high fever, chills, headache, vomiting, myalgia, sleep disturbances, meningeal signs. After 5-7 days, the temperature returns to normal, and after 10 days, the second wave develops and neurological symptoms of CNS damage are added to the meningeal symptoms - pyramidal, cerebellar, autonomic disorders. The course of the disease is favorable, focal symptoms regress. Asthenia persists for a long time.

Very rare disease amoebic meningoencephalitis- severe fulminant course with a very high mortality rate. Amoeba infection occurs in freshwater warm water sources. The incubation period is from 1 to 14 days.

brucellosis meningoencephalitis characterized by damage to the pia mater, the formation of brucellosis granulomas, a long course with paresis and paralysis, mental disorders. The disease is very severe, the patient needs to be hospitalized in a specialized department - infectious, resuscitation, for the period of rehabilitation in the neurological. Diagnosis is individual – mandatory tests, biochemical, serological, brain tomography, lumbar puncture…

Treatment of meningoencephalitis

Treatment is similar to that of encephalitis and meningitis. In the acute period - antibiotics, hormones, symptomatic treatment - individually.

Rehabilitation after meningoencephalitis

In the process of rehabilitation, depending on the residual effects, they use neuroprotectors, antioxidants, agents that improve blood circulation and microcirculation, vitamins B and E, venotonics, anticholinesterase drugs, sedatives, anticonvulsants, physiotherapy, reflexology ... A patient who has had a neuroinfection is observed by a neurologist, is registered at the dispensary and receives individual recommendations. Perhaps and sanatorium-resort treatment.

Neurologist Kobzeva S.V.

On September 23, 2012, it was from meningoencephalitis at the age of 65 that the former Russian Defense Minister Pavel Grachev died. Pavel Grachev was hospitalized on September 12 in serious condition and died on September 23, despite the efforts of doctors. This once again confirms the seriousness of this disease.

The term "meningoencephalitis" includes two nosological forms "encephalitis" and "meningitis". The definition describes the morphological changes that occur against the background of pathology - damage to the white matter and meninges.

Pathology is characterized by high mortality, disability, a large number of disorders. Diagnosis of symptoms of the disease at the beginning of development to prevent dangerous consequences, eliminate damage to functional centers. The effectiveness of treatment depends on the cause, pathogen, prevalence of the inflammatory focus.

The initial signs of pathology are neurological disorders. Neurologists carry out differential diagnostics, which makes it possible to suspect meningoencephalitis, prescribe neuroimaging methods (MRI and CT) in a timely manner.

Meningoencephalitis - what is it

There are congenital and acquired forms. Meningoencephalitis in children occurs with intrauterine infection (cytomegalovirus, chlamydia, meningococcal). Immediately after birth, it is difficult to identify the nosology, since the child cannot tell about the sensations.

In the first month of life, the first signs appear. Only the acute variety is accompanied by multiple changes, which often lead to death. An analysis of the cerebrospinal fluid helps to suspect inflammation of the brain and membranes at the beginning of development.

The procedure is invasive, prescribed according to strict indications. The harmlessness of MRI in meningoencephalitis allows you to prescribe an examination for newborns, infants. The high cost of equipment excludes the possibility of installing devices everywhere.

The main causes of death from inflammatory processes of the soft membrane, cerebral parenchyma:

1. intracerebral edema;
2. infectious shock;
3. Cerebral hypertension;
4. Renal failure.

The consequences of the disease in subacute and chronic form develop for several years.

MRI meningoencephalitis

Meningoencephalitis code according to ICD 10

The international classification of the tenth revision identifies the following types of inflammation of the brain with the code "G04":

1. meningomyelitis;
2. Meningoencephalitis;
3. Myelitis ascending acute.

Classification of meningocephalitis according to the course:

• Chronic - long-term development with a slow increase in symptoms;
• Subacute - erased signs of nosology increase in two to three years;
• Acute - a rapid increase in manifestations helps early diagnosis;
• Lightning - high-speed cerebral damage causes a lethal outcome.

The complexity of pathology verification is hampered by a variety of etiological factors.

Causes of meningoencephalitis

Features of influenza hemorrhagic meningoencephalitis

Nosology is a consequence of influenza. An acute respiratory viral infection provokes a rise in temperature, an increase in the pharyngeal tonsils. Prolonged persistence of infection causes epileptic convulsions.

Fever increases brain damage, but no antiviral treatment has been developed. Vaccination, strengthening immunity are the main measures to counteract the spread of influenza hemorrhagic infection.

Principles of diagnosis of viral meningoencephalitis:

1. Absence of bacteria in brain preparations by Gram staining;
2. Pleocytosis of the cerebrospinal fluid;
3. Detection of enteroviruses, arboviruses, herpesviruses by polymerase chain reaction (PCR).

Severe fatal cases are caused by enteroviruses. More than serotypes of pathogens have been identified, causing a variety of clinical manifestations of the disease. Enteroviral neuroinfection often leads to death, disability.

After a bite of ticks, insects, mosquitoes, the inflammatory process of cerebral tissues is caused by arboviruses if the carrier was infected with microbes. In addition to humans, these pathogens infect horses, dogs, which can also be a source of human infection.

Common encephalitis provoked by arboviruses:

• West Nile fever;
• Encephalitis St. Louis;
• California uniform.

The prevalence of diseases has increased in recent years.

Symptoms of herpetic encephalitis

Activation of herpetic neuroinfection is the cause of death in about seventy percent of adults and children. The absence of antiherpetic therapy excludes the possibility of an effective cure. Only a strong immune system is able to cope with the herpes virus. The weak body of a pregnant woman in the presence of infection becomes a source of infection of the fetus in utero.

Herpes simplex virus type 2 (HSV-2) becomes a source of a mild transient type of neuroinfection. Meningoencephalitis is activated in adolescents with an active sex life.

In newborns, the herpes simplex virus of the first or second type is part of the associated infections. A generalized, multi-organ disease that causes HSV in immunocompromised patients, including AIDS. The absence of pharmaceuticals provokes the death of 2/3 of infants.

The first signs of herpesvirus neuroinfection:

• high fever;
• Strong headache;
• Disorders of behavioral reactions;
• Cerebral symptoms.

The chances of survival are increased by the drug Virolex (Acyclovir). In severe cases, the remedy is ineffective.

Rare forms of viral encephalitis

The defeat of the central nervous system causes the varicella-zoster virus that occurs after the illness. Nosology has symptoms:

• Cerebellar ataxia - discoordination of muscle activity, unsteady gait;
• Acute encephalitis.

Acute manifestation is rare. The varicella-zoster virus is characterized by a chronic course with cycles of remissions and exacerbations, since the pathogen persists in the nerve ganglia. Reactivation of chickenpox is possible with a decrease in immunity.

Rare types of viral meningoencephalitis:

• Cytomegalovirus - destroys cerebral tissues only with immunodeficiencies;
• Mumps - caused by the mumps virus. It is characterized by a mild course, but causes inflammation of the auditory nerve.

The lack of a complete diagnosis excludes the possibility of early detection of neuroinfection.

Clinic of bacterial meningoencephalitis

Pathogenic bacteria enter the brain through the blood, lymphatic fluid. The penetration of microorganisms from the primary focus of internal organs is dangerous due to the resistance of agents to antibiotics used to eliminate the disease.

Types of bacterial meningoencephalitis:

• Brucella;
• Toxoplasmosis;
• Syphilitic;
• tuberculous;
• Meningococcal.

Signs are determined by the type of etiological factor. The defeat of cerebral tissues appears against the background of a primary infection of the internal organs. Congenital species arise due to the ingress of microorganisms into the body of the fetus during childbirth.

Tuberculous encephalitis is formed in people with the presence of primary tuberculosis of different localization. The peak of infection occurs in the spring-autumn period, when the activity of immunity is reduced. Nosology has no specific manifestations. It is diagnosed by laboratory, clinical and instrumental methods.

Mycobacterial infection is difficult to treat. Of the bacterial species, nosology is the most dangerous. The main clinical signs of pathology:

• Violation of concentration;
• Strong headache;
• Cerebral disorders;
• Photophobia;
• Vegetative manifestations;
• neurological disorders;
• Hydrocephalus.

Acute manifestations of the disease are characterized by an increase in temperature up to thirty-nine degrees. Clinical manifestations of the disease are accompanied by fever, joint pain, sleep disturbance, abnormal meningeal symptoms, fever. The average duration of illness is about ten days. Accompanying signs of nosology - lack of appetite, excessive sweating, cerebellar disorders, mobility disorders, positive Rehberg's test. (a person cannot touch the tip of the nose with the index finger of the hand).

The temperature curve against the background of inflammatory changes in the cerebral parenchyma, meninges has a specific course. Initially, the fever increases to 39 degrees. After 5-7 days, the fever drops to subfebrile values ​​​​(38.5 degrees). A second wave is observed on the tenth day. Focal neurological symptoms appear with neuritis, radiculitis, changes in the activity of the heart, pulmonary system, dizziness, convulsions, paresthesia (lack of sensitivity).

The brucellosis species provokes pyramidal symptoms with paresis, paralysis, and muscle cramps.

Pathogens penetrate through the upper respiratory tract. The source of infection are reservoirs, tap water, contaminated vegetables, fruits.

Clinical manifestations of amoebic encephalitis, meningitis:

• Granulomatous inflammation of the white matter is formed for several months. Damage to the membranes in the clinic resembles a volumetric intracerebral formation with the formation of several centers of activity - convulsions, personality disorders, paralysis, paresis;
• Acute variety - duration two weeks. It starts with lightning speed, accompanied by nausea, headaches, a significant increase in temperature. Multiple foci causes death in infants and children.

Early detection, competent drug therapy eliminates the risk of serious complications.

Characteristics of autoimmune encephalitis

The formation of antibodies to brain tissues causes demyelination. The process is long but progressive. Rasmussen's encephalomyelitis is a typical manifestation of an autoimmune lesion of the cerebral parenchyma. Depending on the development of the process, the duration is from five to fifteen years. In most cases, the peak of the clinic falls on six years.

The nosology has been carefully studied by scientists. The causes of occurrence could not be established, but the link to which immunoglobulins are formed was identified. The presence of NMDA receptors is a weak site subject to destruction by the immune system.

There are practical studies showing the nonspecificity of antibodies to glutamate receptors for Rasmussen's encephalomyelitis. Other anti-inflammatory cytokines formed during nosology have been identified.

Meningoencephalitis in newborns

Viruses are the most common causative agent. Intrauterine infection of the baby comes from a mother with glandular fever, measles, rubella, herpes infection, mumps.

The most common symptoms are focal disorders, hyperkinesis, hydrocephalus. Nonspecific manifestations of meningoencephalitis in newborns:

• Eye twitching;
• Difficulty eating from the chest;
• severe fever;
• intoxication syndrome;
• Vomiting reflex;
• Diarrhea;
• Strabismus;
• Accelerated heart rate (tachycardia);
• Muscle twitches.

Neurologists define neurological disorders in the form of Kernig's symptom (the inability to bring the head to the chest due to stiff neck). The cerebrospinal fluid contains an increased number of lymphocytes, protein.

Manifestations of meningoencephalitis in adults

Different symptoms of the disease in an adult are due to different pathogens, especially the course. The incubation period of the disease lasts several weeks.

Symptoms of the clinical stage:

1. muscle stasis;
2. Decreased appetite;
3. Constant fatigue;
4. Headaches without the effectiveness of painkillers.

Inflammatory changes in the meninges lead to meningeal syndrome with special manifestations:

• Nausea;
• speech disorders;
• Interruptions in the activity of the heart;
• Respiratory disorders.

The occurrence of the described manifestations leads to death. The progression of individual signs becomes the cause of disability.

Sequelae of meningoencephalitis

In addition to high mortality, the disease is characterized by dangerous conditions leading to disability. Severe consequences of inflammation of the white matter and meninges:

• Paralysis of the limbs;
• epileptic seizures;
• mental retardation in children;
• Hydrocephalus;
• psychoses;
• Hallucinosis.

Conditions are irreversible. Early verification, competent therapy prevents negative consequences in bacterial types of encephalitis and meningitis. For other forms of nosology, the prognosis is unfavorable.

Diagnosis of inflammation of the brain and soft membranes

The most accurate laboratory method for verifying nosology at the beginning of development is the analysis of cerebrospinal fluid. Turbidity of the cerebrospinal fluid surrounding the brain and spinal cord indicates the presence of an infection. Determination of additional impurities, accumulations of leukocytes and lymphocytes shows a bacterial infection. With pathology, an increase in the content of glucose, protein occurs.

Clinical and instrumental methods of examination of the cerebral parenchyma - radiography, CT, MRI, electroencephalography (EEG). Neuroimaging determines the spread of inflammation, the depth of the lesion, and comorbidities.

Meningoencephalitis (ME) is a severe inflammatory disease of infectious origin.

This disease affects the central nervous system (CNS), affecting the brain and its membranes, sometimes the spinal cord is affected, causing paralysis.

In most cases, ME occurs as a consequence of complicated meningitis (damage to the soft tissues of the brain) and encephalitis (damage to the cerebral fluid).

Such a pathology can be provoked by bacteriological agents, viruses, or amoebas that live freely in fresh water.

Most of them store ticks, which is why the peak of the disease falls on the period of activity of the tick.

Meningoencephalitis can be both a separate pathology and an aggravation in the progression of infectious diseases (tuberculosis, parotitis, influenza, etc.).

In the predominant number of recorded cases, meningococcal encephalitis, as an independent pathology, is noted in children, but its appearance is also noted in adults, with a fairly frequent lethal outcome.

Often, ME leads to serious consequences, characterized by morphological changes in the brain, and only in rare cases is meningoencephalitis treated without consequences.

Therapy for the defeat of meningoencephalitis is not an easy task, since you must first determine the provoking factor, and only then apply the treatment. Since the treatment of viral agents is fundamentally different from the therapy when the body is damaged by bacteria.

How is ME classified?

The classification of meningoencephalitis is implied by the nature of the course of the disease and is the same for all age categories.

There are four forms of the disease:

Also, the classification occurs and the origin of the disease, where two types of damage are distinguished:

• Primary ME progresses when the body is damaged by a virus (from a tick bite), herpes, rabies, etc., when neurosyphilis enters the central nervous system;
• Secondary ME- appears as an aggravation of another disease of infectious origin.

The division according to the nature of the inflammation is final if meningoencephalitis is classified, and helps to apply the most effective therapy for a particular case.

There are three types of inflammation, determined by the state of the brain fluid (shell):

• Hemorrhagic ME characterized by a red tint of cerebral fluid. This happens because with such a lesion in the cerebrospinal fluid there is a large number of erythrocytes (red blood cells);
• Serous ME it is caused by a transparent color, as well as a small amount of protein and a high saturation of lymphocytes;
• Purulent ME- the qualitative characteristic of the cerebrospinal fluid is cloudy (with impurities of pus) and a high indicator of leukocytes.

Fact! In most cases, the provocateur of the development of purulent ME is the defeat of the body by bacteria, and in the other two forms, the effect of viruses on the body.

Is meningoencephalitis contagious or not, and how is it transmitted?

The infectiousness of ME depends on its form and pathogen. Most often they become infected with meningoencephalitis from a tick bite, but the transmission of some of its forms is also possible by airborne droplets. More details about each of the forms and how they are infected are described in the sections below.

Symptoms of meningoencephalitis

Symptoms of the disease are manifested in signs of severe damage to the body by toxins and diseases associated with the brain. Each individual type of meningoencephalitis is characterized by individual symptoms.

Common signs that the body has struck meningoencephalomyelitis are the following symptoms:

• Increase in body temperature;
• Explicit pain in the head;
• Deviations in a normally conscious state (delusions, slowness, etc.);
• Nausea and vomiting;
• Convulsions (in children);
• Increased skin sensitivity;
• Fear of light;
• Increased tone of the occipital muscles;
• A rash of a red hue that disappears with physical influence (noted only in children);
• Violation of reflexes and coordination of movements.

You can also determine the presence of a disease using some methods that absolutely anyone without a medical education can use.

One of them is an attempt to tilt the head of the affected person so that the chin touches the chest. In a healthy state of a person, he easily touches her, reacting even to the slightest movements.

The second way is called the Kernig symptom and consists in asking the potentially affected by meningoencephalitis to bend the leg, in a horizontal position at an angle of ninety degrees, and then unbend it.

With damage to the membranes of the brain, this action will not work.

In order to accurately understand the causes, symptoms and characteristics of the disease, it is necessary to consider each of the types of meningoencephalitis separately.

The following forms are distinguished, which will be discussed in detail in the sections below:

• Viral (herpetic);
• Purulent;
• Amebic;
• Bacterial;
• Brucella;
• Influenza hemorrhagic.

Bacterial ME

The most common provocateur of this type of meningoencephalitis is tuberculosis infection.

It affects the central nervous system and the lining of the brain, and in seventy percent of cases leads to tuberculous ME.

Provocateurs are acting microbacteria. This form of tuberculosis is the most severe form of brain damage.

The clinic of the disease is clearly expressed and well traced:

• Severe headaches that are not relieved by drugs;
• Increasingly developing feeling of weakness, fatigue;
• loss of appetite;
• Disorders of the autonomic system;
• Obvious signs of brain damage;
• Inability to concentrate on one thing;
• Nausea, vomiting;
• Fear of light;
• Signs of lesions (deviations in motor functions);
• Excessive accumulation of fluid in the brain with abnormalities in its normal development.

Fact! The defeat of the body proceeds, under relatively favorable conditions, for a long time and painfully, leaving dangerous burdens. The mortality rate is thirty percent of all registered cases.

The fundamental means in the treatment of bacterial ME are antibiotics, which are prescribed exclusively by the attending physician, after a complete examination and diagnosis.

Viral meningoencephalitis

If the DNA contains the herpes simplex virus, both types, then the body can affect herpetic meningoencephalitis.

The disease can be either independent or progress as a burden, due to damage to the body by an agent of infectious origin.

According to statistics, this disease is observed in the adult category of people, in more than ninety percent of cases. Since the viral pathogen is very common, only a few remain completely healthy from it.

Fact! There is a high risk of viral (herpetic) ME from mother to child, or in newborns (by airborne droplets). The most dangerous is the intrauterine variant of the defeat of the child, leading to dangerous consequences.

With such a meningoencephalitis lesion, two-thirds of infants die at an early age, and the survivors remain disabled.

The development of such a form of the disease as herpetic meningoencephalitis can occur in all four forms of the course, from the asymptomatic to the acute form, which is fatal in the coming hours.

The main signs of this disease are:

• Severe headaches, mainly located in the forehead and crown;
• Increased body temperature;
• Deviations in consciousness (change in behavior, perhaps even final inadequacy);
• General symptoms of brain damage.

Ten days after the onset of the manifestations of viral meningoencephalitis, clinical signs of neuralgia are added, which leads to lesions of the central nervous system.

The disease proceeds more favorably, with a decrease in focal manifestations. Often, to the morphological changes in the brain, with viral meningoencephalitis, DIC is added, which aggravates the patient's condition.

The suppression of the disease occurs with the help of antiviral drugs (Virolex, Acyclovir), which increase the chances of survival, but do not protect against burdens.

Influenza hemorrhagic

Such meningeal encephalitis develops against the background of the flu. The course of the disease is characterized as severe.

And the symptoms are manifested in the following signs:

• Increase in body temperature;
• Chills;
• loss of consciousness;
• epileptic seizures.

Such a state is dangerous because with loss of consciousness and seizures, you can get serious injuries to the body, up to incomparable with life.

brucellosis

For this form of damage to the body by meningoencephalitis, damage to the soft membranes of the brain and the development of brucellosis granules in them are inherent.

The disease proceeds for a long time and is accompanied by paralysis and paresis, as well as mental disorders.
The form of the course is very severe, requiring hospitalization. Accurate diagnosis occurs on an individual basis, after passing tests and conducting additional hardware studies.

Amoebic ME

This type of damage to the body by meningoencephalitis is noted when small-sized free-living protozoa, called amoebas, enter the human body (mainly through the respiratory tract).

They are found in fresh water, tap water, high-temperature mineral springs, or wastewater from power plants, as well as in fungi, vegetables, and contaminated soil.

In some rarely recorded cases, amoebas infect the sinuses of children without adversely affecting them.

This type of meningoencephalitis is most often noted in childhood and adolescence.

The disease can manifest itself in the form of two forms of the course:

• Granulomatous amoebic ME due to slow development (from several weeks to several months). Signs at the initial stage are characterized by similarity with the development of a tumor neoplasm in the brain, or a brain lesion that has a large number of foci. Obvious manifestations are noted in convulsions similar to epileptic ones (mental changes). In some cases, mental disorders can make it difficult to make a diagnosis;
• Acute form of amoebic ME. The illness lasts from two days to two weeks and often has an unexpected onset. The main symptoms begin with headaches, nausea, vomiting, fever. With such a lesion, there are signs similar to meningitis and encephalitis at the same time. The acute form of amoebic meningoencephalitis is the most dangerous, and is generally fatal within seven days of the onset of the first symptoms.

Treatment for these two forms also differs:

• The effectiveness of acute treatment depends on early diagnosis. Otherwise, the patient dies. Amphotericin B therapy is prescribed, or combinations of the following drugs:

1. Chloramphenicol + Rifampicin + Amphotericin B;
2. Ketoconizole + Rifampicin + Amphotericin B.

• The granulomatous form is not yet treatable. Sometimes a combination of the following drugs is used:

1. Sulfadiazine + Fluconazole + Pentamidine + Ketonazole (cream) + topical application of Chlorhexidine;
2. Imidazole derivatives are rarely prescribed.

Fact! Hormone therapy is excluded from treatment, since hormones can aggravate the course of meningoencephalitis and provoke the rapid progression of the disease.

Purulent meningoencephalitis

This type of meningoencephalitis affects the lining of the brain and is caused by a bacterial lesion.

It appears due to the ingestion of meningococci, staphylococci and other bacteria that affect the body.

This form can develop independently, or be burdened by another disease.

Windmill ME

Most often, this type of disease appears as a complication of chickenpox in childhood and infants.

Its course is predominantly severe, but its registration is rarely noted.

Its formation occurs against the background of rashes, fever, lymphadenitis and manifests itself in the following obvious signs:

• Lack of interest in what is happening around;
• Reluctance to move
• Pain in the head;
• dizziness;
• convulsions;
• Fever;
• Vomiting.

What are the consequences of meningoencephalopathy?

If a person has had this disease, then in the future, any burdens may appear.

There are not many reported cases of definitive cure for meningoencephalitis.

Most often, the slightest, but the consequences of the disease remain. It depends on a large number of factors, such as early diagnosis, stage of the disease, and associated burdens and pathologies.

Fact! The deeper the process is developed, the more serious consequences it will entail in the central nervous system.

The diagnosis of ME is especially dangerous for children, because even after meningoencephalitis is cured, the brain membranes are no longer as healthy as before.

Inhibition of the development of the central nervous system, deviations in intellectual activity can be provoked.

There is also a risk of progression of epileptic seizures and seizures.

In adulthood, meningoencephalitis can also lead to mental disorders, personality disorders, complete inadequacy, epileptic seizures, paralysis and dementia, and in some acute forms, to a rapid death.

The most dangerous complications are:

• Paresis;
• hearing loss;
• Intracranial pressure;
• Decline of vision;
• The decline of intellectual activity;
• developmental delays;
• Coma;
• Seizures of epilepsy.

How is it diagnosed?

The main diagnostic method is the puncture of the cerebrospinal fluid, which determines the provoking factor, alleviates the condition and reduces intracranial pressure.

Based on this study, the doctor may prescribe additional laboratory or hardware diagnostic methods.

Effective methods of primary diagnosis are the following methods:

The most effective methods of hardware diagnostics include:

• Computed tomography of the brain;
• Magnetic resonance imaging of the brain - is the most informative. Provides detailed information on the state of the brain;
• Clinical blood test. It will show the general state of health of the patient, and deviations from the norm of elements that saturate the blood;
• Blood chemistry. An extensive blood test that will help determine the condition of almost all organs of the body, including the brain;
• General urine analysis. With the help of this study, doctors diagnose kidney damage factors by monitoring the level of protein and red blood cells in the urine;
• Radiography. Structural abnormalities of the brain can be detected on x-rays.

Treatment of meningoencephalitis

ME therapy takes place in the infectious department. Only timely diagnosis and effectively prescribed therapy will contribute to successful treatment.

With an accurate diagnosis of the form of the disease, the patient is sent to the infectious diseases department, where complex therapy is undertaken.

With purulent meningoencephalitis, it is necessary to use antibiotics, which are selected individually, depending on the characteristics of the organism.

Penicillins, carbapenems, and other drugs may be used. The use of drugs occurs intravenously, for a week to ten days.

When the body is damaged by viral meningoencephalitis, it is necessary to use gamma globulins and interferon inducers, which can be injected both directly into the muscle and into the vein. The duration of such therapy cannot exceed two weeks.

Regardless of the origin of the disease, the following drugs can be prescribed:

• medications for seizures;
• Vitamins and minerals to strengthen the immune system;
• sedative medications;
• Neuroprotective medicines - to restore the normal functioning of the central nervous system;
• Solutions aimed at combating intoxication - accelerate the elimination of toxins from the body;
• Medicines that improve local blood circulation.

Prevention

The main actions in the prevention of meningoencephalitis are the timely and effective treatment of infectious diseases, vaccination and avoidance of contact with encephalitis ticks.

What is the forecast?

With the progression of this disease, the prognosis, most often, is not favorable. There is a high risk of progression of serious complications and death.

The course of ME is determined by the degree of development of the disease, the timeliness of diagnosis and the use of therapy.

Also, the age of the patient plays an important role, since children and the elderly suffer the disease very hard. The most unfavorable prognosis for intrauterine infection is eighty percent of mortality, or disability.

Encephalitic meningitis is a viral, fungal or bacterial disease that causes inflammation of the lining of the brain and spinal cord. It can be fatal if not promptly diagnosed and treated.

Story

There is an opinion that at the time of Hippocrates and Avicenna they knew about the existence of this disease. Could they heal her? Rather no than yes, because even in the modern world it is not always possible to identify the problem in time and respond to it. The first documented case was recorded in Scotland in 1768, but then the connection with the pathogen was not clearly visible. The epidemic was talked about at the beginning of the nineteenth century in Geneva, and although it was managed to be dealt with, it was not the last. Throughout the past and the century before last, encephalitis meningitis appeared in Africa, Europe and the USA.

Until the end of the twentieth century, the death rate from meningitis reached almost one hundred percent, but after penicillin was successfully used against this disease in 1944, the number of lives saved began to increase. Helped and vaccines against common bacterial pathogens, as well as the invention of glucocorticoid drugs.

Causes

According to the etiology, this disease can be divided into three categories:

Infectious (provoked by a specific pathogen);
- infectious-allergic (autoimmune damage to the membranes of the brain in response to infection, vaccination or rheumatic disease);
- toxic (exposure to irritating substances that provoke inflammation).

There are also primary and secondary encephalitic meningitis. As you might guess, the disease is called primary when the focus of infection is located directly in the brain. This occurs with internal injuries (bruise, hematoma), viral or infectious diseases. A secondary disease appears as a complication, for example, otitis media, sinusitis, tuberculosis or syphilis.

Epidemiology

Previously, due to overcrowding, poor hygiene and poor nutrition, encephalitic meningitis occurred mainly in children under five years of age. But now such cases are rare due to the development of medicine and the improvement of living conditions.

Most often get sick in late winter - early spring. At this time, vitamin deficiency and a decrease in immunity, as well as sudden changes in temperature and humidity, are clearly manifested. The constant stay in closed, poorly ventilated rooms also contributes.

Encephalitic meningitis is ubiquitous, but it is most common in Africa. In Russia, the first outbreak of this disease occurred before the start of the Second World War, the second - in the eighties of the last century, and the last - in 1997.

Pathogen

The most common meningococcal and pneumococcal encephalitis meningitis. Streptococcus pneumoniae has more than eighty antigenic varieties. The body itself is motionless, prefers aerobic space, but in critical situations it can temporarily do without oxygen. The shape of the bacterium is oval, less than a micrometer in diameter, it is immobile, has no spores. It develops well on blood media at human body temperature. Pneumococcal encephalitis meningitis is transmitted by airborne droplets from a sick or convalescent person. The microorganism is sufficiently resistant to the effects of drugs, including antibiotics.

Pathogenesis

The disease begins with the fact that the pathogen enters the upper respiratory tract and is fixed on the mucous membrane of the nasopharynx or oropharynx. The virulence factors that pneumococcus has (capsule, teichoic acid, substance C) stimulate the production of prostaglandins, activate the complement system and neutrophilic leukocytes. All of these together do not cause encephalitis meningitis. The reasons for its appearance are deeper. Where the pathogen has colonized the mucosa, inflammation develops in the form of otitis media, sinusitis, frontal sinusitis or tonsillitis. Bacteria multiply, their toxins depress the body's immune system, and with the bloodstream they spread throughout the body, affecting the heart, joints and, among other things, the membranes of the brain.

Clinic

In the clinic, there are three forms that encephalitis meningitis takes:

Acute, accompanied and often fatal;
- protracted, when the symptoms increase gradually;
- recurrent, with small light intervals.

The acute form is characterized by a sudden onset against the background of complete well-being with a sharp increase in temperature to pyretic numbers (39-40 degrees). Pallor, sweating, cyanosis are present, loss of consciousness and convulsions are possible, as well as paresis of the facial muscles. In infants and infants, anxiety is manifested by a monotonous incessant cry. From the increase, a divergence of the sutures of the skull is possible, as well as a bulging of the fontanel. On the second day of the disease, characteristic ones appear, such as stiff neck muscles. After three to four days, the patient falls into a coma, and progressive edema (due to the inflammatory reaction) leads to herniation of the medulla oblongata.

meningeal symptoms

These are signs characteristic of inflammation of the meninges. They appear in the first hours after the onset of the disease and help to accurately diagnose.

1. Pose of a pointing dog (head thrown back, limbs brought to the body).
2. Rigidity of the muscles of the neck and neck (the doctor cannot passively bend the patient's head due to the increased tone of the extensor muscles).
3. (the doctor bends the patient's leg in the hip and knee joint, but when trying to straighten it meets resistance).
4. The upper symptom of Brudzinsky (when the head is bent, the legs are pulled up to the body).
5. Medium (flexion of the legs with pressure in the suprapubic region).
6. Lower symptom of Brudzinsky (When one leg is passively flexed, the second is also brought to the stomach).
7. Symptom Lessage (the baby is lifted, supporting the armpits, while his legs are pressed against the body).
8. Symptom Mondonesi (painful pressure on the eyeballs).
9. Bekhterev's symptom (pain during tapping on the zygomatic arch).
10. Hypersensitivity to irritants, photo and sound fear.

In children

For an adult, it is difficult to endure a disease such as encephalitis can be even more tragic, since they rarely complain of ailments, do not notice insect bites and have reduced immunity. Boys get sick more often than girls, and the disease is more severe.

To protect your child, you need to dress him warmer in the spring and autumn, consult a doctor in time at the slightest sign of illness, and examine him every couple of hours on the street in the summer for tick bites and other blood-sucking insects.

Diagnostics

For the doctor, first of all, it is important to confirm the diagnosis of encephalitis meningitis. Is he contagious? Undoubtedly. Therefore, the patient must be placed in a separate box or in the infectious disease department, after conducting a preliminary epidemiological survey. Then it is necessary to collect an anamnesis of life and health, to find out complaints. The physical examination consists of checking for meningeal signs and taking temperature. For laboratory tests, blood and cerebrospinal fluid are taken.

In the general blood test, there is an increase in the level of leukocytes with a predominance of young forms, the absence of eosinophils and a sharply increased ESR up to sixty millimeters per hour. Liquor will be cloudy, opalescent, with a greenish tinge. It is dominated by neutrophils and protein, and the amount of glucose is reduced. To determine the pathogen, blood, sputum or cerebrospinal fluid is sown on a nutrient medium.

Treatment

If an ambulance doctor or there is a suspicion of encephalitis meningitis, then the patient is immediately hospitalized in a neurological hospital. Treatment begins immediately, without waiting for laboratory confirmation of the diagnosis. A strict bed rest, high-calorie diet is observed.

Begin with symptomatic and pathogenetic therapy. First of all, you need to cleanse the body of toxins that bacteria produce, as well as reduce intracranial pressure and thin the blood. For this, the patient is intravenously injected with saline with glucose and diuretics. Because excessive flooding of the body can lead to herniation of the medulla oblongata and instant death. In addition, drugs to improve microcirculation, vasodilators and nootropics support brain activity.

Etiological therapy consists in antibiotic therapy (benzylpenicillins, fluoroquinolones, cephalosporins).

Exodus

It all depends largely on how quickly and successfully they began to treat encephalitis meningitis. The consequences can be minor if help is provided in a timely manner. And at the same time, with a severe and rapid course of the disease, mortality reaches eighty percent. There may be several reasons for this:

Edema of the brain and its herniation;
- cardiopulmonary insufficiency;
- sepsis;
- DIC syndrome.

Prevention

Encephalitic meningitis can be prevented by vaccinating children from two to five years of age among those at risk. It is also recommended for people over sixty-five years of age. This vaccination is included in the official WHO vaccination schedule and is used in most countries of the world.

At the moment, in third world countries, the public is still afraid of the diagnosis of encephalitis meningitis. Can we heal it? Yes, definitely. But success depends on how quickly help is provided and how.

Meningoencephalitis is a combined inflammation of the membranes of the brain and the substance of the brain.

Causes

Meningoencephalitis can be infectious, toxic or infectious-allergic. The disease can be caused by bacteria (meningococci, streptococci, gram-positive and gram-negative bacteria), viruses (tick-borne encephalitis, West Nile virus, cytomegalovirus, influenza, herpetic), protozoa (Toxoplasma gondii, Trypanosoma brucei, Naegleria fowleri). Rarely, autoimmune reactions are the cause.

Meningoencephalitis can be a complication of encephalitis, meningitis, purulent dental or ENT diseases, chickenpox, rubella, measles.

Symptoms of meningoencephalitis

The symptoms of meningoencephalitis are similar to those of meningitis. Patients are concerned about: headache, nausea, vomiting, chills. Body temperature is elevated. The onset of the disease is acute.

There are symptoms of irritation of the meninges (symptoms of Brudzinsky, Kernig, stiff neck, photophobia). Also, there are signs of brain damage (impaired coordination, hemiparesis, damage to the cranial nerves, anisoreflexia). There are violations of higher nervous function (mental deviations, apraxia, alexia, aphatic disorders).

Possible complication of meningoencephalitis with abscess formation of the cerebellum and brain.
Features of the clinical picture in meningoencephalitis depend on the type of disease.

Diagnostics

Diagnosis of meningoencephalitis is carried out according to the results of serological and biochemical tests, brain tomography, examination of cerebrospinal fluid.

Types of disease

Depending on the nature of the course and the causes of occurrence, the following types of disease are distinguished:

• • Amoebic meningoencephalitis is caused by amoebas of the genera Naegleria and Hartmanella, which penetrate the nasal mucosa while swimming in an infected reservoir;
  • Brucellosis meningoencephalitis occurs with neurobrucellosis when soft brain tissue is infected;
  • Vaccine meningoencephalitis can develop 5-12 days after vaccination (more often after smallpox vaccination);
  • Hemorrhagic meningoencephalitis (Leuchtenstern's syndrome) is of an infectious-allergic origin and is most often caused by the influenza virus;
  • Hummous meningoencephalitis - meningoencephalitis with tertiary syphilis;
  
  
  • Herpetic meningoencephalitis - serous or hemorrhagic meningoencephalitis caused by the herpes simplex virus;
  • Meningoencephalitis ornithosis - serous-hemorrhagic meningoencephalitis against the background of a severe course of ornithosis;
  • Mumps meningoencephalitis, predominantly serous, caused by the mumps virus;
  • Rheumatic meningoencephalitis - meningoencephalitis with rheumatism;
  • Anthrax meningoencephalitis - hemorrhagic, arising from the septic form of anthrax (anthrax);
  • Typhoid meningoencephalitis - meningoencephalitis with typhus (typhus);
  • Toxoplasmosis meningoencephalitis - meningoencephalitis in newborns and infants with generalized toxoplasmosis;
  • Tuberculous meningoencephalitis;
  • Cytomegalic meningoencephalitis - meningoencephalitis in newborns and infants with cytomegaly.

Patient's actions

If a person has symptoms such as loss of consciousness, rapid convulsions, eye movement disorders, paresis, it is urgent to call an ambulance to him.

Treatment of meningoencephalitis

Treatment is carried out in a hospital and depends on the type and nature of the inflammation, as well as on the stage of the course.
With viral meningoencephalitis, antiviral therapy is prescribed, with a disease of a bacterial nature, antibiotic therapy. Regardless of the type of disease, in addition to the main treatment, interferons, immunostimulants, and corticosteroids are prescribed.

During the rehabilitation period, antioxidants, neuroprotectors, agents for improving microcirculation and blood circulation, vitamin B and vitamin E, venotonics, sedatives, anticholinesterase and anticonvulsants are used. Additionally, reflexology and physiotherapy are used.

Patients who have had meningoencephalitis should be regularly observed by a neurologist and follow the doctor's recommendations. Shown spa therapy to strengthen the body.

Complications

Meningoencephalitis is characterized by a severe course and a high percentage of deaths.

In patients with weakened immune systems, as well as in case of untimely diagnosis and treatment, the disease can be complicated by paralysis, epilepsy, paresis.

In children with herpetic encephalitis, postnecrotic cysts may form during the recovery period. Characterized by mental retardation, hydrocephalus.

Complications of meningoencephalitis include disorders of the brain. In young children, the disease can lead to a delay in mental and mental development.

Prevention of meningoencephalitis

The main means of specific prevention of the disease is vaccination against Haemophilus influenzae, vaccination with meningococcal and pneumococcal vaccines. Usually it is carried out in childhood.

To prevent the disease in people who have been in contact with the patient, chemoprophylaxis with antibacterial drugs is carried out.

Causes of the inflammatory process in the central nervous system

Meningoencephalitis is characterized by polyetiology, after all, a variety of circumstances can contribute to the development of the pathological process. Along with infectious pathogens, infectious-allergic and toxic factors can play their negative role. All the causes that cause meningitis and encephalitis are at the same time prerequisites for the formation of a concomitant disease (inflammation of the brain and pia mater). From this, the severity of an isolated disease and its prognosis, of course, are aggravated.

And yet, the most common cause of dangerous inflammation localized in the central nervous system are infections:

• Bacterial - this is all kinds of coccal flora (strepto-, staphylo-, pneumo-, meningococci), listeria, tubercle bacillus, etc .;
• Viral - both widespread and rare viruses even for the vast territory of the Russian Federation: tick-borne encephalitis, measles, chickenpox, influenza, herpes, rabies, mumps, West Nile fever, etc .;
• Infections caused by protozoa, such as toxoplasma, malarial plasmodium;
• Diseases caused by the penetration into the body of mutant species of amoebas living in fresh water.

A predisposing factor in this pathology is age - in children, due to the insufficient development of the immune system and the failure of the blood-brain barrier, meningoencephalitis is diagnosed much more often than in adults. True, in this case, older people can be equated with children - their immunity is low, the body can no longer fully resist infections. The risk group for this inflammatory process is also made up of patients with acute or chronic pathology of the ENT organs - sinusitis, sinusitis, mastoiditis, etc. In such patients, as a rule, purulent meningoencephalitis develops as a complication.

How does the pathogen manage to enter the brain from the external environment?

How the infectious agent enters the body depends on the type of pathogen, for example:

1. 1. The most common path is laid by ixodid ticks, which, when bitten, bring a neurotropic virus. By the way, a tick is able to introduce several pathogens at once (mixed infection), which are very difficult to identify by laboratory methods in the shortest possible time. This option is often found in adults who like to spend time in parks and forests, but do not really care to protect their skin with clothes and shoes to the maximum;
   2. Meningococcal infection - is transmitted by airborne droplets, therefore, it is most often observed in children whose body is not able to fully fight it;
   
   
   3. In newborns, especially premature ones, this pathology can originate even from the gestational period (intrauterine infection), a certain proportion in the incidence of meningoencephalitis takes over the passage through the birth canal;
   4. Amoebas are most often caught by swimming in polluted water bodies. The disease will not spare either adults or children who like to have fun swimming with diving and floundering, because the nose and throat are the widest gates for the entry of an infectious agent;
   5. People become infected by quenching their thirst with water from the same reservoirs (“having drunk from a hoof”), because it is not visible to the naked eye that it “swarms” in the water.

Infection with the causative agent of the membranes of the brain occurs mainly by the hematogenous route, the lymphogenous route of spread is in second place, however a direct hit of the bacterial flora during the breakthrough of purulent cavities or open craniocerebral injuries is also not excluded.

How is this inflammatory process classified?

The patient may not be interested in what doctors call this process, but they distinguish the following forms of the disease:

• • Primary meningoencephalitis, which develops as a result of infection with arbovirus (with a tick bite), herpes virus, rabies, the causative agent of typhoid fever, as a result of penetration into the central nervous system of treponema pallidum (neurosyphilis);
  • Secondary process - it, as a rule, acts as a complication of another pathology of an infectious nature (chickenpox, measles, tuberculosis, purulent diseases of the upper respiratory tract caused by bacterial flora).

The nature of the course of the inflammatory process in the central nervous system can also include several forms:

1. 1. Fulminant option - the disease develops rapidly, the patient's condition deteriorates sharply in a matter of hours, often death occurs in such a situation;
   2. Spicy meningoencephalitis - the clinical picture unfolds rather quickly, but not as rapidly as in the case of a fulminant form, so doctors have more time to provide assistance;
   3. Subacute course - there is a slow development of erased symptoms;
   4. Chronic the inflammatory process is a sluggish development of events, signs of inflammation in the brain are poorly expressed, the disease proceeds with remissions and exacerbations.

In addition, meningoencephalitis differs in the nature of the inflammatory reaction, which is determined by the quality of the cerebrospinal fluid:

• • Serous- transparent cerebrospinal fluid, a small amount of protein, the number of lymphocytes is sharply increased;
  • Purulent- against the background of cloudy (purulent) cerebrospinal fluid, a huge number of leukocytes;
  • Hemorrhagic- cerebrospinal fluid acquires a reddish tint due to the admixture of blood; in cerebrospinal fluid, in addition to white blood cells, a large number of erythrocytes.

The cause of purulent meningoencephalitis in most cases is bacterial infection(pyogenic coccal flora, Pseudomonas aeruginosa, etc.), the development of serous and hemorrhagic forms is mainly due to exposure viruses.

General symptoms

The difficulty in diagnosing meningoencephalitis lies in the fact that the pathogen in the first hours of the disease does not “say” anything about itself, and each form can have its own specific signs, which, however, can resemble a wide range of pathological conditions. However, it is useful to know the general symptoms that are characteristic, in general, for the entire group of diseases called "meningoencephalitis":

1. 1. High body temperature;
   2. Severe headache;
   3. Violation of consciousness (excitation or lethargy, deafness, delirium, etc.);
   4. Nausea and vomiting;
   5. Convulsions are possible (in children);
   6. Meningeal signs - Kernig, Brudzinsky, stiff neck, tension symptoms, photophobia, increased sensitivity of the skin, etc .;
   7. In children, the above signs are often supplemented by a red rash that disappears with pressure (manifestations of meningococcal infection).

Of course, the patient himself or his relatives can hardly understand all the meningeal signs, but many people can easily master some of them on their own. For example, try to tilt the patient's head so that the chin touches the sternum: in the absence of meningeal symptoms, this is easy, the patient will respond to even the slightest downward movement.

If you suspect a dangerous ailment, you can ask a person with suspected meningoencephalitis to passively bend the leg (lying on his back) at an angle of 90 degrees (hip and knee joint), and then make him straighten the limb. If the meninges are irritated, this will not work, therefore this condition should be regarded as a meningeal sign (Kernig's symptom).

Separate forms

The described pathological condition is also classified according to the type of pathogen, and if it is reliably established, the disease is presented in a more accurate version, indicating its culprit. For example, herpetic meningoencephalitis (which, of course, is also viral), tuberculous, implying a bacterial nature, the name amoebic already indicates that protozoa have become the culprit of the disease.

Viral meningoencephalitis (on the example of herpetic)

Herpetic meningoencephalitis, the main cause of which is a DNA-containing herpes simplex virus of both the first and second types, can occur as an independent form (in adults against the background of a decrease in immunity) or act as an integral component of a generalized viral infection (in newborns and infants). age). It is known that HSV is found in adults in more than 90% of cases. Due to the wide spread of the pathogen, few people manage to avoid meeting with HSV, however, the highest probability of “catching” it is present when passing through the birth canal of an infected woman and in early childhood (airborne transmission). The most dangerous is intrauterine infection of the fetus, which leads to serious consequences (up to 2/3 of newborns die in infancy, the rest will suffer the fate of childhood disabilities).

What to expect from herpetic meningoencephalitis is impossible to predict in advance, its course is quite variable:

• • Acute meningoencephalitis;
  • Chronic process;
  • The development of the disease under the guise of other pathological conditions of the central nervous system (neoplasms, epilepsy, strokes, dementia);
  • Almost asymptomatic.

The first signs of this disease:

1. 1. Intense headache, localized in most cases in the frontal and parietal region;
   2. High body temperature;
   3. Violation of consciousness, changes in behavioral functions, up to complete inadequacy;
   4. Cerebral symptoms, against which it is often possible to observe focal manifestations.

The viral nature of the disease (especially in the case of acute meningoencephalitis) does not bode well for the patient: DIC is often added to the destructive changes in the brain, which aggravates the already serious condition of the patient.

The therapeutic effect is mainly due to the antiviral drug acyclovir (virolex), which significantly increases the chances of life, but, unfortunately, does not protect against serious consequences.

Video: lecture on herpetic encephalitis in children

Bacterial meningoencephalitis (tuberculous, etc.)

The culprits of tuberculosis of the central nervous system and meninges, which in 70% of cases leads to tuberculous meningoencephalitis, are mycobacteria (Mycobacterium tuberculosis). Representing the most severe form of tuberculous brain damage, this form of the disease gives a rather vivid clinical picture:

• • Severe headache, not subject to analgesics;
  • Progressive malaise and general weakness, loss of appetite;
  • Nausea, vomiting, photophobia;
  • Decreased concentration;
  • Vegetative disorders;
  • Severe cerebral symptoms;
  • Presence of meningeal signs;
  • Symptoms of focal lesions (impaired motor functions, damage to craniocerebral insufficiency), which indicates the involvement of the meninges and brain matter;
  • development of hydrocephalus.

The course of the disease under more or less favorable circumstances (mortality is approximately 30%) is long and painful, leaving serious consequences.

The main treatment for bacterial meningoencephalitis is antibiotics.

Video: lecture on tuberculous meningoencephalitis

Amoebic meningoencephalitis

Amebic meningoencephalitis results from entry (usually through the upper respiratory tract) of small, free-living protozoa called amoebas.

In addition to fresh water, it is possible to meet an amoeba in tap water, in hot waters of mineral springs or in discharged from power plants, as well as in the soil, on vegetables and mushrooms. In rare cases, an amoeba can inhabit the nasal passages of children without causing them much harm.

Amebic meningoencephalitis is most commonly diagnosed in children and young adults. The pathological condition can manifest itself in two forms:

• Acute meningoencephalitis with an incubation period of 2 days to 2 weeks and a fairly sudden onset. Clinical manifestations debut with a sharp headache, nausea and vomiting, a rapid rise in body temperature. With this variant of the disease, the symptoms of meningitis first manifest themselves (meningeal signs, cerebral symptoms), signs of damage to the brain substance are somewhat delayed and develop later. This form is extremely dangerous, most patients do not manage to live more than a week from the onset of initial signs;
• Granulomatous amoebic meningoencephalitis characterized by a sluggish course, weeks or even months can pass. Symptoms at the initial stage are more like the development of a mass formation in the brain or a multifocal lesion, manifesting itself as convulsive seizures resembling epileptic seizures, hemiparesis, and personality changes. In other cases, the symptoms of a mental disorder come to the fore, making diagnosis difficult.

Treatment of acute meningoencephalitis of this origin, since it often ends tragically, can sometimes be successful, but only if diagnosed very early. Patients are prescribed monotherapy with amphotericin B or a combination of drugs:

• • Amphotericin B + rifampicin + chloramphenicol;
  • Amphotericin B + rifampicin + ketoconizole.

As for the granulomatous form, to date, reliable methods of control have not been found. Use combinations of sulfadiazine + fluconazole, pentamidine + ketonazole (cream) + chlorhexidine (topically). Sometimes imidazole derivatives help. Hormones in this case are excluded - they will further aggravate the course of the process and lead to the rapid progression of the disease.

Consequences of meningoencephalitis

People who have suffered such a dangerous condition can expect various "surprises" in the future from this disease. There are not so many cases when meningoencephalitis (of any origin) was cured, like a runny nose. Usually, although small, barely noticeable or completely invisible to strangers, the consequences remain. It depends on many factors: when a person suffered an ailment, which pathogen “tried”, how the process proceeded, what state of immunity, etc. The severity of the consequences will depend on how deeply the pathological process penetrates, which zones it captures, how much the structures of the central nervous system (CNS).

The most pronounced consequences are expected in the case of intrauterine infection with the virus. If the baby did not die in the womb, then later she will have to deal with hydrocephalus, epilepsy, and mental disorders. Although such children do not grow well, their mental development lags even further behind. In addition, given the defeat of the central nervous system in the early stages of its formation, paresis and paralysis are considered a natural phenomenon.

Meningoencephalitis is of particular danger to children, because in the event of a favorable completion of the process, the membranes and substance of the brain are still not as healthy as before the disease. The further development of the central nervous system often slows down, the intellect suffers, and although some children continue to do well at school (who are lucky), the exact sciences begin to be difficult for them. In addition, there is always the danger of developing convulsive syndrome and epilepsy.

Adults also have problems, the least of which are hearing and vision loss. And yet, it would seem that intellectual abilities are formed, therefore, no troubles are expected from this side. But no, various types of dementia, mental disorders against the background of epileptic seizures, paresis and paralysis can lie in wait for any person, even if he is yesterday's scientist or a simple hard worker.

However, some people are really lucky, except for dispensary registration with a neurologist and periodic examinations, nothing else reminds them of the suffering they experienced.

What causes such a state?

The following reasons can provoke the presented pathology:

1. Encephalitis of the primary group.
2. Encephalitis of the secondary group, including measles, chickenpox, rubella.
3. demyelinating process.
4. Mumps meningoencephalitis of acute form.
5. The causes of meningoencephalitis may lie in the inflammation of the paranasal sinuses.

Classification

If we consider the disease according to the nature of the course, then in adults and in children it can be:

1. Lightning - the symptoms are of a rapid nature, which contributes to the rapid violation of the condition and leads to death.
2. Acute - the symptoms of the disease in children and adults occur very quickly and contribute to the violation of the general condition of the patient.
3. Subacute - the manifestations of the disease affect the patient's body slowly and are erased in nature.
4. Chronic - flows sluggishly, does not have severe symptoms, has a period of exacerbation and remission.

How does the disease manifest itself?

Often, meningoencephalitis in children and adults is the consequences of a general septic process. The following symptoms are distinguished:

• rise in temperature indicators;
• headache;
• excited state;
• vomit;
• convulsive conditions;
• photophobia, hyperesthesia.

Meningeal symptoms are replenished with signs of brain damage: impaired coordination of movements, anisoreflexia, mental deviations, alexia, aphatic disorders.

In addition, the symptoms of the disease differ in each person, taking into account the type of meningoencephalitis. In children and adults, the following forms of the disease can be diagnosed:

• influenza hemorrhagic;
• herpetic;
• purulent;
• viral;
• amebic;
• brucellosis.

Influenza hemorrhagic

Influenza hemorrhagic meningoencephalitis is a consequence of influenza. This form of pathology has a severe course. Her symptoms are as follows:

• rise in temperature to a high level;
• chills;
• loss of consciousness;
• epileptic seizures.

herpetic

This type of pathology can act as an independent disease or occur in combination with a generalized viral infection. Herpetic meningoencephalitis in newborns and in young children occurs in a generalized form, in adults, as a separate disease. Such an ailment can be acute or chronic, sometimes with a complete absence of a clinical picture.

Viral

This type of disease can occur due to the presence of tick-borne encephalitis virus. Infection occurs through the milk of affected animals. As a rule, viral meningoencephalitis makes itself felt in the spring and summer. Initially, symptoms are acute and include:

• high temperature;
• chills
• vomiting
• headaches;
• bad dream.

After 10 days, the manifestations of the disease are complemented by neurological symptoms, resulting in damage to the cerebellum and central nervous system. The disease proceeds favorably, and focal manifestations regress. For a long time, sewage remains.

Amebic

Very rarely amoebic meningoencephalitis is diagnosed in newborns, young children and adults. This pathology is considered very dangerous, as it has a high mortality rate. Amoebic meningoencephalitis can be picked up in freshwater reservoirs. The latent period lasts 1–14 days.

brucellosis

This form of the disease is characterized by damage to the pia mater with the formation of brucellosis granules. The duration of the course is long and is accompanied by paresis and paralysis, a violation of the mental state.

The brucellosis form is characterized by a very severe course, the patient is placed in a hospital. Diagnosis occurs on an individual basis. Here you will need to take tests, undergo a brain tomography, and a lumbar puncture.

Purulent

This disease affects the lining of the brain and is bacterial in nature. Purulent meningoencephalitis occurs due to the penetration of meningococci, staphylococci, bacterial agents into the body. The purulent form of the disease can be primary or secondary.

tuberculosis

Tuberculous meningoencephalitis is characterized by secondary inflammation of the meninges. As a rule, the disease affects people suffering from various forms of tuberculosis. Very often, tuberculous meningoencephalitis is diagnosed in young children and newborns. Most often, the disease affects the body in the winter-spring period, although there is a risk of infection at any time of the year.

Tuberculous meningoencephalitis has the following manifestations:

• apathy;
• increased irritability;
• fatigue;
• bad sleep;
• poor appetite;
• frequent headaches.

windpox

Varicella meningoencephalitis is a complication of chickenpox in young children and newborns. As a rule, varicella meningoencephalitis is severe, despite the fact that the disease rarely affects. Chickenpox meningoencephalitis is formed against the background of a rash, fever and lymphadenitis. Recognize varicella meningoencephalitis by the following symptoms:

• apathy;
• adynamia;
• headache;
• dizziness;
• vomit;
• convulsive state;
• febrile delirium.

Complications

If we are talking about such a form of the disease as a viral one, then its consequences are a common phenomenon. If the patient's immunity is weakened or diagnostics and treatment were carried out late, this will lead to complications such as paralysis, paresis and epileptic seizures.

The consequences of the herpetic form are accompanied by the formation of postnecrotic cysts, mental retardation, hydrocephalus may occur.

The consequences of the disease are disruption of the functioning of the brain. The further life of the patient will depend on how serious the damage to the central nervous system is.

If the child suffered an illness at an early age, then later this can cause a delay in mental and mental development. Complications of meningoencephalitis in newborns prone to the formation of its generalized forms are very severe.