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  • Tension Type Headache and Encephalitis

    Încărcat de

    Pernel Jose Alam Micubo
    12 vizualizări11 pagini
    Tension type headache is the most common type of headache characterized by bilateral tight band-like discomfort that builds slowly and may persist continuously for many days. It can be diagnosed clinically without accompanying symptoms like nausea. Viral encephalitis is diffuse brain inflammation often seen with meningitis that causes altered mental status, seizures, or neurological deficits. It is diagnosed through CSF examination showing pleocytosis and PCR/cultures identifying the viral cause. Key signs to rule in encephalitis are fever, headache, lethargy, and incoherence while ruling out normal lymphocyte count and absence of motor/cranial nerve deficits.

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    Rule In and Rule Out

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    Tension type headache is the most common type of headache characterized by bilateral tight band-like discomfort that builds slowly and may persist continuously for many days. It can be diagnosed clinically without accompanying symptoms like nausea. Viral encephalitis is diffuse brain inflammation often seen with meningitis that causes altered mental status, seizures, or neurological deficits. It is diagnosed through CSF examination showing pleocytosis and PCR/cultures identifying the viral cause. Key signs to rule in encephalitis are fever, headache, lethargy, and incoherence while ruling out normal lymphocyte count and absence of motor/cranial nerve deficits.

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    © All Rights Reserved
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    12 vizualizări11 pagini

    Tension Type Headache and Encephalitis

    Încărcat de

    Pernel Jose Alam Micubo
    Tension type headache is the most common type of headache characterized by bilateral tight band-like discomfort that builds slowly and may persist continuously for many days. It can be diagnosed clinically without accompanying symptoms like nausea. Viral encephalitis is diffuse brain inflammation often seen with meningitis that causes altered mental status, seizures, or neurological deficits. It is diagnosed through CSF examination showing pleocytosis and PCR/cultures identifying the viral cause. Key signs to rule in encephalitis are fever, headache, lethargy, and incoherence while ruling out normal lymphocyte count and absence of motor/cranial nerve deficits.

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    din 11

    Tension Type Headache

    &
    Viral Encephalitis
    Tension Type Headache
    • Most common type of headache
    • chronic head-pain syndrome
    • Characterized by bilateral tight, band-like
    discomfort
    • Pain builds slowly, fluctuates in severity and
    may persist more or less continuously for
    many days
    • Can be episodic or chronic (>15 days/mos)
    Tension Type Headache
    • Diagnosis is more on clinical approach
    • Patient should have headache w/o
    accompanying features of nausea and
    vomiting, photophobia, phonophobia,
    osmophobia, throbbing, and aggravation with
    movement
    Tension Type Headache
    Rule In
    • Headache
    • Frontal-Occipital region

    Rule Out
    • Fever
    • Nausea and vomiting
    Encephalitis
    • diffuse inflammation of the brain parenchyma and is
    often seen simultaneously with meningitis
    • usually in viral origin
    • Patients frequently have signs and symptoms of
    meningitis (e.g., headache, fever, photophobia,
    nuchal rigidity).
    • patient with encephalitis commonly has an altered
    level of consciousness (confusion, behavioral
    abnormalities), or a depressed level of consciousness
    ranging from mild lethargy to coma, and evidence of
    either focal or diffuse neurologic signs and symptoms
    Encephalitis
    • hallucinations, agitation, personality change,
    behavioral disorders, and a frankly psychotic state
    • Focal or generalized seizures
    • Focal neurologic disturbance
    – Aphasia
    – Ataxia
    – Upper or lower motor neuron patterns of weakness
    – Involuntary movements (e.g., myoclonic jerks, tremor)
    – Cranial nerve deficits (e.g., ocular palsies, facial
    weakness)
    Encephalitis
    Laboratories
    • CSF Examination
    – CSF pleocytosis (>5 cells/μL) occurs in >95% of
    immunocompetent patients with documented
    viral encephalitis

    • CSF PCR
    – primary diagnostic test for CNS infections caused
    by CMV, EBV, HHV-6, and enteroviruses
    Encephalitis
    Laboratories
    • CSF Culture
    – To rule out nonviral causes
    • CSF IgM antibody test
    – best test for WNV encephalitis
    • MRI, CT, and EEG
    • Brain Biopsy
    – reserved for patients who fail in other diagnostics and
    treatment
    Encephalitis
    Rule In
    • Fever
    • Headache
    • Lethargic or asthenic
    • Agitated
    • Patient at times incoherent
    Encephalitis
    Rule Out
    • Differential count for Lymphocytes is normal
    • (-) movement changes
    • (-) CN deficits
    • (+) Babinski sign
    • (+) Kernig’s Sign
    • (+) Brudzinski Sign

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