Dematerialized state

Introduction Severe patients with toxic encephalopathy may have varying degrees of visual impairment, hearing loss, cranial nerve palsy, paralysis or multiple paralysis, mental decline and other mental disorders, while others change from coma to de-septic or go The brain is in a state of rigidity, and those with mild symptoms can recover, but some can still have inattention, reduced learning ability, abnormal behavior and personality changes. Infectious toxic encephalopathy, also known as acute toxic encephalitis, is a brain toxic reaction caused by acute infection with toxins. More common in children 2 to 10 years old, infancy is rare.

Cause

Infectious toxic encephalopathy, also known as acute toxic encephalitis, is a brain toxic reaction caused by acute infection with toxins. More common in children 2 to 10 years old, infancy is rare.

Acute bacterial infections are the main causes, such as sepsis, pneumonia, dysentery, typhoid fever, scarlet fever, diphtheria, pyelonephritis, etc. Secondly, acute respiratory infections and malaria caused by influenza virus, parainfluenza virus, syncytial virus, adenovirus can also cause The disease. Toxemia, metabolic disorders and hypoxia cause brain edema as the main pathogenesis.

an examination

Related inspection

Cerebrospinal fluid protein quantification

More than the first three days of acute infection, some children occur several hours after the onset of acute infection. Children with high fever, severe headache, vomiting, irritability and paralysis, and even coma, often have seizures, duration can be long or short, mostly for systemic orthostatic or systemic tonic. In addition, there are often positive pyramidal tract signs, limb paralysis, aphasia, pupil abnormalities. There are obvious meningeal irritation signs. The awake children have different outcomes depending on their severity. Severe patients may have varying degrees of visual impairment, hearing loss, cranial nerve palsy, paralysis or multiple paralysis, mental decline and other mental disorders, while others change from coma to de-sexual state or to the brain tonic state, light Most of the patients can recover, but some can still have inattention, reduced learning ability, abnormal behavior and personality changes.

Differential diagnosis

According to the patient's history of acute infectious diseases with high fever, and vomiting, as well as various psychiatric symptoms and brain neurological signs, cerebrospinal fluid pressure is increased and its routine and biochemical tests are normal, which can be diagnosed. Often need to be identified with the following diseases:

First, viral encephalitis: viral encephalitis transmitted by insect vectors is seen in summer and autumn. Other viral encephalitis can be sporadic. More subacute onset, cerebrospinal fluid examination in addition to increased pressure, but also showed a slight turbid cerebrospinal fluid, increased white blood cell count and protein.

Second, encephalitis after viral infection: in the case of measles, influenza, mumps, chickenpox and other viral infections 1 to 2 weeks after the onset of the primary disease began to relieve. After pathological changes, the white matter of the brain has scattered demyelination and mononuclear cell infiltration around the small veins, mild increase of cerebrospinal fluid leukocytes, elevated protein and oligoclonal IgG bands.

Third, acute bacterial meningitis: acute onset, high fever, severe headache and vomiting, can quickly appear convulsions, mental disorders and disturbance of consciousness, meningeal irritation signs, cerebrospinal fluid changes significantly, white blood cell count increased significantly, neutrophils accounted for absolute Advantages, sometimes phagocytosis of bacteria in the white blood cells, increased protein, sugar and chloride decreased.

Fourth, febrile seizures: more common in infants and young children. Generally, when the body temperature of an infectious disease rises above 38 °C, it can occur in a generalized tonic or tonic. It usually occurs once only once, and no obvious brain damage remains after the attack. Heat can also occur later.

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