Encephalitis Lethargica Lewis Tan Maria Perwein What it

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Encephalitis Lethargica Lewis Tan Maria Perwein

Encephalitis Lethargica Lewis Tan Maria Perwein

What it is Ethiology: • Greek: enképhalos “brain”, Latin: lethargica „lethargic, somnolent Definition: •

What it is Ethiology: • Greek: enképhalos “brain”, Latin: lethargica „lethargic, somnolent Definition: • “Encephalitis lethargica” or ”von Economo disease” is an atypical form of encephalitis, also known as a type of "sleepy sickness“ • =Encephalitis that causes lethargy, uncontrollable sleep attacks and a temporary parkinson like dysfunction

What it is Discovery: • First described in 1917 by the neurologist Constantin von

What it is Discovery: • First described in 1917 by the neurologist Constantin von Economo and the pathologist Jean-Rene Cruchet • 1915 -1926 an epidemic of LE spread around the world at the same time as the influenza (since then only isolated cases occur)

Causes • Not known for certain • Originally some scientist thought that EL was

Causes • Not known for certain • Originally some scientist thought that EL was caused by the influenza pandemic in 1918 • Von Economo concluded that the influenza virus is not related to EL at the same time

Causes • Today’s statements: • encephalitis of midbrain and BG with lymphatic infiltration •

Causes • Today’s statements: • encephalitis of midbrain and BG with lymphatic infiltration • EL might be immune-mediated (beneficial effects of steroid treatments • many diseased people had pharyngitis and evidence linking the reaction to prior streptococcal throat that caused an immune response was found

Symptoms • • • High fever Sore throat Headache Lethargy Double vision Delayed physical

Symptoms • • • High fever Sore throat Headache Lethargy Double vision Delayed physical and mental response Sleep inversion and catatonia Muscular pain and tremors In severe cases patients may enter a coma-like state that can ultimate in death

Prevalences • Mostly found within European countries • Based on 112 cases from the

Prevalences • Mostly found within European countries • Based on 112 cases from the years 1915 to 1940, most died within 2 weeks of EL onset Øanalysis revealed: § cortical damage in 75% § damage to the meninges and brainstem in 50% § Substantia Nigra in 13%

Differential diagnosis • Trypanosomiasis (sleepy sickness) transmitted via Tsetse fly • Parkinsonism • Postencephalitic

Differential diagnosis • Trypanosomiasis (sleepy sickness) transmitted via Tsetse fly • Parkinsonism • Postencephalitic Parkinson Disease • Narcolepsy

Treatment • Oral and i. v. : Zolpidem and steroids • artificial respiration •

Treatment • Oral and i. v. : Zolpidem and steroids • artificial respiration • physical, speech and occupational therapy • Music therapy http: //www. youtube. com/watch? v=pi. X-ht. WIh 7 I&feature=youtu. be

Any questions?

Any questions?

Sources • • • http: //www. ncbi. nlm. nih. gov/pubmed/19490429 http: //www. ncbi. nlm.

Sources • • • http: //www. ncbi. nlm. nih. gov/pubmed/19490429 http: //www. ncbi. nlm. nih. gov/pubmed/11594935 http: //en. wikipedia. org/wiki/Encephalitis_lethargica http: //brain. oxfordjournals. org/content/127/1/21 http: //www. medlink. com/medlinkcontent. asp