Treatment Of Viral Encephalitis Research Articles

The Adjuvant Efficacy of Angong Niuhuang Pill in the Treatment of Viral Encephalitis: A Meta-Analysis of Randomized Controlled Trials.

This meta-analysis aims to evaluate the efficacy of Angong Niuhuang Pill (ANP) as an adjuvant therapy in the treatment of viral encephalitis. Seven databases (PubMed, Cochrane Library, Embase, SinoMed, CNKI, VIP and WanFang) were included for literature retrieval from inception to July 2023. Randomized controlled trials comparing ANP plus conventional therapy with conventional therapy alone were eligible. Pooled effect sizes and 95% confidence intervals (CIs) were calculated for evaluating efficacy and safety. Sensitivity analysis and publication bias assessments were performed for analyzing the inconclusiveness of findings. 13 studies involving 1045 cases were included for meta-analysis. Adjuvant treatment with ANP increased the probability of the total effective rate by 17% compared with conventional treatment (Risk ratios (RR) = 1.17, 95%CI [1.08, 1.27]). The disappearance time of clinical syndromes and signs was significantly decreased after adjuvant treatment with ANP, including the time of defervescence (weighted mean difference (WMD) = -1.59, 95%CI [-2.09, -1.09]), the time of consciousness recovery (WMD = -1.79, 95%CI [-2.06, -1.51]), the time of headache disappearance (WMD = -1.51, 95%CI [-1.93, -1.08]), the time of tic disappearance (WMD = -1.88, 95%CI [-2.39, -1.36]). The adjuvant efficacy of ANP for treating viral encephalitis (VE) appears to improve the total effective rate and shorten the disappearance time of clinical syndromes. More high-quality randomized controlled trials (RCTs) are needed to support our findings.

Ferroptosis contributes to JEV-induced neuronal damage and neuroinflammation

Ferroptosis is a newly discovered prototype of programmed cell death (PCD) driven by iron-dependent phospholipid peroxidation ​accumulation, and it has been linked to numerous organ injuries and degenerative pathologies. Although studies have shown that a variety of cell death processes contribute to JEV-induced neuroinflammation and neuronal injury, there is currently limited research on the specific involvement of ferroptosis. In this study, we explored the neuronal ferroptosis induced by JEV infection in vitro and in vivo. Our results indicated that JEV infection induces neuronal ferroptosis through inhibiting the function of the antioxidant system mediated by glutathione (GSH)/glutathione peroxidase 4 (GPX4), as well as by promoting lipid peroxidation mediated by yes-associated protein 1 (YAP1)/long-chain acyl-CoA synthetase 4 (ACSL4). Further analyses revealed that JEV E and prM proteins function as agonists, inducing ferroptosis. Moreover, we found that treatment with a ferroptosis inhibitor in JEV-infected mice reduces the viral titers and inflammation in the mouse brains, ultimately improving the survival rate of infected mice. In conclusion, our study unveils a critical role of ferroptosis in the pathogenesis of JEV, providing new ideas for the prevention and treatment of viral encephalitis.

Retracted: Acyclovir Combined with Naloxone in the Treatment of Viral Encephalitis: A Meta-Analysis.

[This retracts the article DOI: 10.1155/2022/8593251.].

Low Dose versus High Dose Steroids in Treatment of Viral Encephalitis

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BRIEF REVIEW OF VIRAL ENCEPHALITIS

Encephalitis is a disease characterised by inflammation of the encephalon. An important element to take into account in this pathology is that it has several causes, among which viral and metabolic are the most important. This clinical picture generally manifests itself with headache, altered mental state, seizures, focal signs, movement disorders, and in some cases also manifested with meningeal or cortical signs, depending on whether it is multi-focal or focal. It is important to consider post-infectious or para-infectious processes in encephalitis. The most important thing is always to take into account onset, progression and speed, together with contact with sick people. In suspected viral encephalitis, aciclovir 10 mg/kg/every 8 hours for 14 days is recommended. The aim of this literature review is to show how the treatment of viral encephalitis has changed over the years, considering possible elements that may improve or worsen the prognosis. KEY WORDS: viral encephalitis, central nervous system, herpes simplex virus.

Acyclovir Combined with Naloxone in the Treatment of Viral Encephalitis: A Meta-Analysis.

Background The aim of this study was to systematically evaluate the efficacy and prognosis of acyclovir combined with naloxone in the treatment of patients with viral encephalitis (VE). Methods PubMed, Web of Science, Embase, CNKI, and WanFang Data were searched for relevant literature published between 2000 and 2021. Meta-analysis was performed using Stata16.0 software. The treatment group was treated with acyclovir combined with naloxone, and the control group was treated with acyclovir alone. Results A total of 12 studies with 986 participants were included. Compared with the control group, the treatment group could not only significantly improve the treatment response rate (OR = 5.53, 95% CI: 3.50, 8.74; P ≤ 0.001), but also reduce the incidence of adverse reactions (OR = 0.25, 95% CI: 0.17, 0.38; P ≤ 0.001). In addition, the combined treatment significantly inhibited the levels of inflammatory factors and neuron-specific enolase (NSE) in VE patients. The time for cerebrospinal fluid to return to normal (SMD = −2.73, 95% CI: −2.96, −2.51; P ≤ 0.001), as well as the disappearance time of meningeal irritation (SMD = −3.58, 95% CI: −4.96, −2.20; P ≤ 0.001), headache (SMD = −3.87, 95% CI: −5.84, −1.91; P ≤ 0.001), convulsion (SMD = −3.65, 95% CI: −4.56, −2.75; P < 0.001), tic (SMD = −4.083, 95% CI: −5.18, −2.98; P ≤ 0.001) and disturbance of consciousness (SMD = −4.96, 95% CI: −6.28, −3.63; P ≤ 0.001) in the treatment group were significantly shorter than those in the control group. Conclusion A combination of acyclovir and naloxone can reduce the inflammatory response and shorter the time to symptom relief and disappearance, which is worthy of clinical promotion.

Diagnostic Value of the Electroencephalogram and Cerebrospinal Fluid in Viral Encephalitis.

Electroencephalogram (EEG) and cerebrospinal fluid (CSF) are widely used in the clinical diagnosis of viral encephalitis (VE), but their value in the diagnosis of VE and the detection rate of abnormal indicators need to be further supported by more clinical data. In this study, routine laboratory testing, biochemical examinations of cerebrospinal fluid (CSF) and EEG characteristics were performed in patients with VE to guide the diagnosis and treatment of VE in clinical settings. A total of 330 patients with VE were enrolled in the Department of Neurology of the Third Affiliated Hospital of Zunyi Medical University from January 1, 2015 to January 30, 2020. EEG, routine testing and assessment of biochemical indicators of CSF were performed within 10 days after admission, and the results were analyzed by paired χ 2 test to compare the diagnostic value of EEG and CSF for VE. In 330 cases of VE, 283 cases (85.76%) had abnormal EEG, and 189 cases (57.27%) had abnormal CSF indicators. The incidence of EEG abnormalities was higher than that of CSF indicators, and the difference was statistically significant ( P <0.05). Both the EEG and CSF analysis are valuable indicators in the diagnosis of VE patients. Compared with the CSF examination, the EEG examination had a better diagnostic efficacy for the diagnosis of VE. In addition, a normal EEG or a normal CSF level cannot exclude VE, and it is still necessary to develop new diagnostic indicators to cover all viral encephalitides.

Clinical Study of Modified Sub-Hibernation Therapy Combined with Ganciclovir on Patients with Viral Encephalitis

Viral encephalitis is an infectious disease of the nervous system caused by multiple viruses entering the brain. This disease is extremely harmful to the human body and has a high mortality rate. Modified sub-hibernation therapy and ganciclovir are the most commonly used treatments for viral encephalitis. The purpose of this article is to further explore the clinical effect of modified sub-hibernation therapy combined with ganciclovir on patients with viral encephalitis. Thirty viral encephalitis patients with severe illness and long-term illness were taken as the research object, and the patients were divided into three groups according to the condition and their own conditions, a control group, a ganciclovir treatment group and a modified sub-hibernation therapy combined ganciclovir observation group. The control group did not receive any treatment, the treatment group was treated with ganciclovir alone, and the observation group was treated with modified sub-hibernation therapy combined with ganciclovir. The diagnosis and prognosis of all patients were analyzed and studied. The results of the study showed that the treatment effective rate of the ganciclovir treatment group was 85.7%, and three patients relapsed after discharge from the hospital. The recurrence rate was 30%. The total effective rate of the modified sub-hibernation therapy combined with the ganciclovir observation group was 95.3%, only one person relapsed after discharge, the recurrence rate was 10%. It can be seen that the treatment of viral encephalitis with modified sub-hibernation therapy combined with ganciclovir has a very good therapeutic effect and the disease recurrence rate is low. It is the first choice for the treatment of viral encephalitis.

The Role of Intravenous Immunoglobulins in Treatment of Viral Encephalitis in Children

The Role of Intravenous Immunoglobulins in Treatment of Viral Encephalitis in Children

Steroids in Treatment of Viral Encephalitis

Steroids in Treatment of Viral Encephalitis

Viral Encephalitis: A Hard Nut to Crack

AbstractViral encephalitis is inflammation of brain that manifests as neurological complication of viral infections. There are quite a good number of viruses, for example, human herpes virus, Japanese encephalitis, and enteroviruses that can result in such a dreadful condition. Geographical location, age, gender, immune status, and climatic conditions also contribute to the establishment of this disease in an individual. Clinical signs and symptoms include fever, headache, altered level of consciousness, changed mental status, body ache, seizures, nausea, and vomiting. Effective management of this disease relies on timely diagnosis that in turn depends on apt and suitable investigation techniques. Traditional investigations have thinned out these days owing to the fact that advanced molecular technologies have been introduced to the diagnostic field. Treatment of viral encephalitis mainly involves symptomatic relieve from fever, malaise, myalgia along with measures to reduce viral load in the patient. This review mentions about all the possible aspects of viral encephalitis starting from etiology to the management and preventive measures that include immunization and vector control.

Clinical features and surgical treatment of epilepsy after viral encephalitis

Encephalitis is an acute inflammatory process of the brain parenchyma, which is often caused by viral infection. It is an vital cause of acute symptomatic seizures and subsequent epilepsy. The incidence of unprovoked and recurrent seizures after previous infections of the central nervous system is high and accounts for 1%~5% of the cases of epilepsy. Viral encephalitis (VE) is directly caused by viral infection. The occurrence of seizures after VE is associated with poor prognosis. In survivors of VE, among other neurological sequelae, the risk of developing epilepsy is increased 10-fold. The risk of severe neurological sequelae after VE is particularly high in very young children. Studies on seizure occurrence, possible underlying mechanisms, clinical characteristics, and clinical treatment (especially surgical treatment) of VE have yielded only limited detailed data. We reviewed the most recent literature on the clinical features and surgical treatment of post-VE epilepsy.

Clinical features and surgical treatment of epilepsy after viral encephalitis

Encephalitis is an acute inflammatory process of the brain parenchyma, which is often caused by viral infection. It is an vital cause of acute symptomatic seizures and subsequent epilepsy. The incidence of unprovoked and recurrent seizures after previous infections of the central nervous system is high and accounts for 1%~5% of the cases of epilepsy. Viral encephalitis (VE) is directly caused by viral infection. The occurrence of seizures after VE is associated with poor prognosis. In survivors of VE, among other neurological sequelae, the risk of developing epilepsy is increased 10-fold. The risk of severe neurological sequelae after VE is particularly high in very young children. Studies on seizure occurrence, possible underlying mechanisms, clinical characteristics, and clinical treatment (especially surgical treatment) of VE have yielded only limited detailed data. We reviewed the most recent literature on the clinical features and surgical treatment of post-VE epilepsy.

Analysis of clinical outcome and treatment of viral encephalitis with bilateral thalamic damage

Objective To investigate the clinical outcome and treatment characteristics of viral encephalitis with bilateral thalamic damage so as to improve its prognosis. Methods Twelve cases of viral encephalitis with bilate-ral thalamic damage were collected during September 2012 to June 2013 by head MRI.These cases were retrospectively studied with the data of medical history, physical examination, laboratory and brain function monitoring and treatment.The relationship between treatment and prognosis was studied during 2 years of follow-up. Results All patients began with the rapid onset, accompanied by fever, coma, and convulsions.Delirium and involuntary movement occurred during the recovery period.Six cases(50.0%) received ventilator assisted ventilation.In the acute phase, electroencephalogram(EEG) showed diffuse slow wave and 4 cases(33.3%) had status epilepticus on EEG.Ten cases discharged from hospital had long-term oral anti epileptic drugs, which lasted 6 months in 3 cases, 1 year in 4 cases, and 2 years in 3 cases for maintaining EEG stability.Head MRI indicated white matter demyelination besides the gray matter damage within the thalamus.All 12 patients underwent methylprednisolone impact treatment and 6 cases had effective reversal within 1 week of onset with better tolerance, and the other 6 cases received treatment in subacute stage and 5 of them accelerated reco-very and 1 case had sense improvement, but died after giving up therapy.After 3 months courses, 8 cases(66.7%) got gross motor and swallowing function recovered to normal, and 3 cases had left unilateral limb movement disorder.After 2 years of follow-up, 11 cases had normal motor, intelligence returned to normal in 9 cases, and 2 cases had mild mental retardation. Conclusions Viral encephalitis complicated with bilateral thalamic damage is characterized by acute onset, serious manifestations, idiopathic progress; in the subacute stage it is most likely to develop white matter demyelination.The key to control the disease is to block the inflammatory immune response quickly, and give patients large dose methylprednisolone treatment can effectively curb the progress of the disease.In the sub acute phase, it can promote the recovery, safe and effective.The long-term prognosis will be good with the reasonable treatment at early stage of the disease. Key words: Thalamus; Encephalitis, viral; Treatment

Study on the significance of MRI and cerebrospinal fluid cytology in the diagnosis of viral encephalitis (meningitis)

Objective To explore the significance of magnetic resonance imaging (MRI) and cerebrospinal fluid cytology in the diagnosis and treatment of viral encephalitis (meningitis). Methods The head MRI and cerebrospinal fluid data of 189 patients with viral encephalitis (meningitis) were reviewed, and early changes of cerebrospinal fluid cyotology of patients with normal or abnormal MRI findings were analysed retrospectively. Results Among 189 viral encephalitis (meningitis) patients, 96 (50.79%) patients presented abnormal MRI, and 129 (68.25%) patients presented abnormal cerebrospinal fluid cytological findings. In patients with abnormal MRI the abnormality rate of cerebrospinal fluid cytological findings was 72.92% (70/96), while in patients with normal MRI it was 63.44% (59/93), the difference was significant (P = 0.000). Conclusion In the early stage of viral encephalitis (meningitis) MRI changes appear later than abnormal cerebrospinal fluid cytological findings, but both of them are important for clinical diagnosis and treatment of this disease. DOI：10.3969/j.issn.1672-6731.2011.05.013

Treatment of Viral Encephalitis

Several viruses may cause central nervous system diseases with a broad range of clinical manifestations. The time course of the viral encephalitis can be acute, subacute, or chronic. Pathologically there are encephalitis with direct viral entry into the CNS in which brain parenchyma exhibits neuronal damaging and viral antigens and there are postinfectious autoimmune encephalitis associated with systemic viral infections with brain tissue presenting perivascular aggregation of immune cells and myelin damaging. Some virus affect previously healthy individuals while others produce encephalitis among imunocompromised ones. Factors such evolving lifestyles and ecological changes have had a considerable impact on the epidemiology of some viral encephalitis [e.g. West-Nile virus, and Japanese B virus]. Citomegalovirus and JC virus are examples of infections of the brain that have been seen more frequently because they occur in immunocompromised patients. In the other hand many scientific achievements in neuroimaging, molecular diagnosis, antiviral therapy, immunomodulatory treatments, and neurointensive care have allowed more precise and earlier diagnoses and more efficient treatments, resulting in improved outcomes. In this article, we will present the current drug options in the management of the main acute and chronic viral infection of the central nervous system of immunocompetent and immunocompromised adults, focusing on drugs mechanisms of action, efficacy, and side effects. The early diagnosis and correct management of such diseases can reduce mortality and neurological sequelae; however, even with recent treatment advances, potentially devastating outcomes are still possible.

A Randomized Trial of Ligustrazini Hydrochlorioi in the Treatment of Viral Encephalitis in Children

Introduction: Chuanxiong is a herb used in traditional Chinese medicine for the Treatment of viralencephalitis. In animal studies it has shown to inhibit the synthesis and activity of Thromboxane (TXA2)and abate the imbalance between Thromboxane (TXA2) and Prostacyclin (PGI2). As a result, cerebraledema, ischemia and hypoxia could be improved. The aim of this study is to evaluate its effect in thetreatment of viral encephalitis in children. Methodology: Ninety-nine patients with viral encephalitiswere randomly divided into two groups. Ligustrazini Hydrochlorioi (LH) consisting of 51 cases (males30, females 21; age 5 years and nine month ±8 years and 2month) was given LH 4mg/kg per day in 100-300mls of 10% glucose and infused intravenously over a three to four hour period, for 7 days as a courseof treatment. A control groups of 48 cases (males 31, females 17; age 5 years and three month ±4 yearsand three month) received the conventional treatment of Vitamin C(2.0-3.0g), Coenzyme A(100u) andAdenosine Triphosphate (ATP) (40mg) in 100-300 mls of 10% glucose infused intravenously daily for 7days. Results: The total response rate in the LH group and the control group were 94.12% and 68.75%respectively (u=3.271 p&lt;0.05). The average time to improvement was 4.29±1.41 days and 7.31±2.66days respectively. No adverse effect was observed in both groups. Conclusion: We conclude that LH isan effective, safe and well tolerated treatment for children encephalitis.Key words: Cerebral Oedema; Encephalitis; Ligustrazini HydrochlorioiDOI: 10.3126/jnps.v30i2.3451J. Nepal Paediatr. Soc. May-August, 2010 Vol 30(2) 119-122