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Diseases » Encephalitis » Causes

Causes of Encephalitis



Contents

List of causes of Encephalitis

Following is a list of causes or underlying conditions (see also Misdiagnosis of underlying causes of Encephalitis) that could possibly cause Encephalitis includes:

More causes: see full list of causes for Encephalitis

Causes of Encephalitis (Diseases Database):

The follow list shows some of the possible medical causes of Encephalitis that are listed by the Diseases Database:

Source: Diseases Database

Causes of Encephalitis: Online Medical Books

16 MEDICAL BOOKS ONLINE! Review excerpts from medical books online, free, without registration, for more information about the causes of Encephalitis.

Nuchal Rigidity: Differential Diagnosis
(In A Page: Pediatric Signs and Symptoms)

  • Stress
    –Causing muscles to tighten and stiffen
  • Injury/whiplash secondary to trauma
  • Cervical adenitis
    • Meningitis
      –Presence of nuchal rigidity has 30% sensitivity, 95% specificity
  • Encephalitis
  • Subarachnoid hemorrhage
  • Retropharyngeal abscess
    –Associated with fever, sore throat (84%)
  • Epiglottitis
  • Focal dystonia
  • Torticollis, congenital or acquired
    • Tetanus
      –Associated with trismus, risus sardonicus, opisthotonus, muscle spasms
  • Dental abscess
  • Pharynx/larynx spasms
  • Chemical meningitis
    –After spinal anesthesia or lumbar puncture
  • Parameningeal infection
    –Lesion on MRI/CT
  • Posterior fossa tumor
  • Thyroiditis
  • Rheumatoid arthritis
  • Cervical arthritis
  • Pneumonia
  • Cervical spine osteomyelitis
  • Poliomyelitis
  • Trichinosis
  • Chagas disease
  • Infantile Gaucher disease
  • Maple syrup urine disease
  • Kernicterus
  • Toxins
    –Phenothiazines
    –Strychnine
    –Lead poisoning
    –Methanol poisoning
    –Hypervitaminosis A

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Brudzinski's sign: Medical causes
(Handbook of Signs & Symptoms (Third Edition))

❑ Arthritis. With severe spinal arthritis, a positive Brudzinski's sign can occasionally be elicited. The patient may also report back pain (especially after weight bearing) and limited mobility.

❑ Meningitis. A positive Brudzinski's sign can usually be elicited 24 hours after the onset of meningitis, a life-threatening disorder. Accompanying findings may include headache, a positive Kernig's sign, nuchal rigidity, irritability or restlessness, deep stupor or coma, vertigo, fever (high or low, depending on the severity of the infection), chills, malaise, hyperalgesia, muscular hypotonia, opisthotonos, symmetrical deep tendon reflexes, papilledema, ocular and facial palsies, nausea and vomiting, photophobia, diplopia, and unequal, sluggish pupils. As ICP rises, arterial hypertension, bradycardia, widened pulse pressure, Cheyne-Stokes or Kussmaul's respirations, and coma may develop.

❑ Subarachnoid hemorrhage. Brudzinski's sign may be elicited within minutes after initial bleeding in subarachnoid hemorrhage, a life-threatening disorder. Accompanying signs and symptoms include the sudden onset of severe headache, nuchal rigidity, altered LOC, dizziness, photophobia, cranial nerve palsies (as evidenced by ptosis, pupil dilation, and limited extraocular muscle movement), nausea and vomiting, fever, and a positive Kernig's sign. Focal signs — such as hemiparesis, vision disturbances, or aphasia — may also occur. As ICP rises, arterial hypertension, bradycardia, widened pulse pressure, Cheyne-Stokes or Kussmaul's respirations, and coma may develop.

READ BOOK EXCERPT ONLINE »

Kernig's sign: Medical causes
(Handbook of Signs & Symptoms (Third Edition))

Lumbosacral herniated disk

A positive Kernig’s sign may be elicited in patients with lumbosacral herniated disk, but the cardinal and earliest feature is sciatic pain on the affected side or on both sides

Associated findings include postural deformity (lumbar lordosis or scoliosis), paresthesia, hypoactive deep tendon reflexes in the involved leg, and dorsiflexor muscle weakness.

Meningitis

A positive Kernig’s sign usually occurs early with meningitis, along with a fever and, possibly, chills

Other signs and symptoms of meningeal irritation include nuchal rigidity, hyperreflexia, Brudzinski’s sign, and opisthotonos. As intracranial pressure (ICP) increases, headache and vomiting may occur. In severe meningitis, the patient may experience stupor, coma, and seizures. Cranial nerve involvement may produce ocular palsies, facial weakness, deafness, and photophobia. An erythematous maculopapular rash may occur in viral meningitis; a purpuric rash may be seen in those with meningococcal meningitis.

Spinal cord tumor

Kernig’s sign can be elicited occasionally, but the earliest symptom is typically pain felt locally or along the spinal nerve, commonly in the leg

Associated findings include weakness or paralysis distal to the tumor, paresthesia, urine retention, urinary or fecal incontinence, and sexual dysfunction.

Subarachnoid hemorrhage

Kernig’s and Brudzinski’s signs can be elicited within minutes after the initial bleed

The patient experiences a sudden onset of a severe headache that begins in a localized area and then spreads, pupillary inequality, nuchal rigidity, and a decreased level of consciousness. Photophobia, a fever, nausea and vomiting, dizziness, and seizures are possible. Focal signs include hemiparesis or hemiplegia, aphasia, and sensory or visual disturbances. Increasing ICP may produce bradycardia, increased blood pressure, respiratory pattern change, and rapid progression to coma.

READ BOOK EXCERPT ONLINE »

Nuchal rigidity: Medical causes
(Handbook of Signs & Symptoms (Third Edition))

Cervical arthritis

With cervical arthritis, nuchal rigidity develops gradually. Initially, the patient may complain of neck stiffness in the early morning or after a period of inactivity. Stiffness then becomes increasingly severe and frequent. Pain on movement, especially with lateral motion or head turning, is common. Typically, arthritis also affects other joints, especially those in the hands.

Encephalitis

Encephalitis is a viral infection that may cause nuchal rigidity accompanied by other signs of meningeal irritation, such as positive Kernig’s and Brudzinski’s signs. Usually, nuchal rigidity appears abruptly and is preceded by a headache, vomiting, and a fever. The patient may display a rapidly decreasing LOC, progressing from lethargy to coma within 24 to 48 hours of onset. Associated features include seizures, ataxia, hemiparesis, nystagmus, and cranial nerve palsies, such as dysphagia and ptosis.

Listeriosis

If listeriosis spreads to the nervous system, meningitis may develop. Signs and symptoms include nuchal rigidity, a fever, a headache, and a change in the LOC. Initial signs and symptoms include a fever, myalgia, abdominal pain, nausea, vomiting, and diarrhea.

Gender Cue:Listeriosis infection during pregnancy may lead to premature delivery, infection of the neonate, or still birth.

Meningitis

Nuchal rigidity is an early sign of meningitis and is accompanied by other signs of meningeal irritation — positive Kernig’s and Brudzinski’s signs, hyperreflexia and, possibly, opisthotonos. Other early features include a fever with chills, a headache, photophobia, and vomiting. Initially, the patient is confused and irritable; later, he may become stuporous and seizure-prone or may slip into a coma. Cranial nerve involvement may cause ocular palsies, facial weakness, and hearing loss. An erythematous papular rash occurs in some forms of viral meningitis; a purpuric rash may occur in meningococcal meningitis.

Subarachnoid hemorrhage

Nuchal rigidity develops immediately after bleeding into the subarachnoid space. Examination may detect positive Kernig’s and Brudzinski’s signs. The patient may experience an abrupt onset of a severe headache, photophobia, a fever, nausea and vomiting, dizziness, cranial nerve palsies, and focal neurologic signs, such as hemiparesis or hemiplegia. His LOC deteriorates rapidly, possibly progressing to coma. Signs of increased ICP, such as bradycardia and altered respirations, may also occur.

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Meningococcal infections: Causes and incidence
(Professional Guide to Diseases (Eighth Edition))

Meningococcal infections usually occur among children (ages 6 months to 1 year) and men, usually military recruits or those enrolled at institutions, such as colleges, because of overcrowding.

N. meningitidis has seven serogroups (A, B, C, D, X, Y, and Z); group A causes most epidemics. Transmission takes place through inhalation of an infected droplet from a carrier (an estimated 2% to 38% of the population). The bacteria localize in the nasopharynx. After incubating approximately 3 to 4 days, they spread through the bloodstream to joints, skin, adrenal glands, lungs, and the central nervous system. The tissue damage that results (possibly due to the effects of bacterial endotoxins) produces symptoms and, in fulminating meningococcemia and meningococcal bacteremia, hemorrhage, thrombosis, and necrosis.

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West Nile encephalitis: Causes and incidence
(Professional Guide to Diseases (Eighth Edition))

WNV is transmitted to humans by the bite of a mosquito (primarily the Culex species) infected with the virus. It's considered the primary vector for WNV and the source of the August 1999 outbreak in New York, New Jersey and Connecticut. Mosquitoes become infected by feeding on birds contaminated with the West Nile virus and then transmitting it to humans and animals during a blood meal or “bite.” (See Transmission routes of West Nile virus, page 256.)

Ticks have been found infected with WNV in Africa and Asia only. The role of ticks in the transmission and maintenance of the virus remains uncertain, and to date they aren't considered vectors for WNV in the United States.

The Centers for Disease Control and Prevention has reported that there is no evidence that a person can contract the virus from handling live or dead infected birds. However, avoid barehanded contact when handling dead animals, including birds, and use gloves or double plastic bags to dispose of a carcass. Report the finding to the local health department.

READ BOOK EXCERPT ONLINE »

Brudzinski's sign: Medical causes
(Professional Guide to Signs & Symptoms (Fifth Edition))

Arthritis

A positive Brudzinski’s sign can occasionally be elicited in patients with severe spinal arthritis. The patient may also report back pain (especially after weight bearing) and limited mobility.

Meningitis

A positive Brudzinski’s sign can usually be elicited 24 hours after the onset of meningitis, a life-threatening disorder. Accompanying findings may include headache, a positive Kernig’s sign, nuchal rigidity, irritability or restlessness, deep stupor or coma, vertigo, fever (high or low, depending on the severity of the infection), chills, malaise, hyperalgesia, muscular hypotonia, opisthotonos, symmetrical deep tendon reflexes, papilledema, ocular and facial palsies, nausea and vomiting, photophobia, diplopia, and unequal, sluggish pupils. As ICP rises, arterial hypertension, bradycardia, widened pulse pressure, Cheyne-Stokes or Kussmaul’s respirations, and coma may develop.

Subarachnoid hemorrhage

A positive Brudzinski’s sign may be elicited within minutes after initial bleeding in subarachnoid hemorrhage, a life-threatening disorder. Accompanying signs and symptoms include sudden onset of a severe headache, nuchal rigidity, altered LOC, dizziness, photophobia, cranial nerve palsies (as evidenced by ptosis, pupil dilation, and limited extraocular muscle movement), nausea and vomiting, fever, and a positive Kernig’s sign. Focal signs—such as hemiparesis, vision disturbances, and aphasia—may also occur. As ICP rises, arterial hypertension, bradycardia, widened pulse pressure, Cheyne-Stokes or Kussmaul’s respirations, and coma may develop.

READ BOOK EXCERPT ONLINE »

Nuchal rigidity: Medical causes
(Professional Guide to Signs & Symptoms (Fifth Edition))

Cervical arthritis

With this disorder, nuchal rigidity develops gradually. Initially, the patient may complain of neck stiffness in the early morning or after a period of inactivity. Stiffness then becomes increasingly severe and frequent. Pain on movement, especially with lateral motion or head turning, is common. Typically, arthritis also affects other joints, especially those in the hands.

Encephalitis

This viral infection may cause nuchal rigidity accompanied by other signs of meningeal irritation, such as positive Kernig’s and Brudzinski’s signs. Usually, nuchal rigidity appears abruptly and is preceded by headache, vomiting, and fever. The patient may display a rapidly decreasing LOC, progressing from lethargy to coma within 24 to 48 hours of onset. Associated features include seizures, ataxia, hemiparesis, nystagmus, and cranial nerve palsies, such as dysphagia and ptosis.

Listeriosis

If this bacterial infection spreads to the nervous system, meningitis may develop. Signs and symptoms include nuchal rigidity, fever, headache, and change in LOC. Initial signs and symptoms include fever, myalgias, abdominal pain, nausea, vomiting, and diarrhea.

Meningitis

Nuchal rigidity is an early sign of this disorder and is accompanied by other signs of meningeal irritation—positive Kernig’s and Brudzinski’s signs, hyperreflexia and, possibly, opisthotonos. Other early features include fever with chills, headache, photophobia, and vomiting. Initially, the patient is confused and irritable; later, he may become stuporous and seizure-prone or may slip into coma. Cranial nerve involvement may cause ocular palsies, facial weakness, and hearing loss. An erythematous papular rash occurs in some forms of viral meningitis; a purpuric rash may occur in meningococcal meningitis.

Subarachnoid hemorrhage

Nuchal rigidity develops immediately after bleeding into the subarachnoid space. Examination may detect positive Kernig’s and Brudzinski’s signs. The patient may experience abrupt onset of severe headache, photophobia, fever, nausea and vomiting, dizziness, cranial nerve palsies, and focal neurologic signs, such as hemiparesis or hemiplegia. His LOC deteriorates rapidly, possibly progressing to coma. Signs of increased ICP, such as bradycardia and altered respirations, may also occur.

READ BOOK EXCERPT ONLINE »

Encephalitis: Causes
(Handbook of Diseases)

Encephalitis generally results from infection with arboviruses specific to rural areas. In urban areas, it’s most frequently caused by enteroviruses (coxsackievirus, poliovirus, and echovirus).

Other causes include herpesvirus, mumps virus, human immunodeficiency virus, adenoviruses, and demyelinating diseases after measles, varicella, rubella, or vaccination.

Between World War I and the Depression, a type of encephalitis known as lethargic encephalitis, von Econ-omo’s disease, or sleeping sickness occurred with some regularity. The causative virus was never clearly identified, and the disease is rare today. Even so, the term sleeping sickness persists and in many cases is mistakenly used to describe other types of encephalitis as well. The most recent outbreak of mosquito-borne encephalitis was West Nile encephalitis.

READ BOOK EXCERPT ONLINE »

West Nile encephalitis: Causes
(Handbook of Diseases)

WNV is transmitted to humans by the bite of an infected mosquito (primarily the Culex species). Mosquitoes become infected by feeding on infected birds.

Ticks infected with WNV have been found in Africa and Asia, but their role in transmission and maintenance of the virus is uncertain; they aren’t considered vectors for WNV in the United States.

The Centers for Disease Control and Prevention has reported that there’s no evidence that a person can contract the virus from handling live or dead infected birds. However, barehanded contact when handling dead animals, including dead birds, should be avoided; if a dead animal must be handled, gloves or other protective measures should be used to dispose of the carcass. A dead bird is a sign that there may be infected mosquitoes in the area; findings should be reported to the nearest Emergency Management Office.

READ BOOK EXCERPT ONLINE »

Kernig's sign: Medical causes
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)

Lumbosacral herniated disk

A positive Kernig’s sign may be elicited in patients with lumbosacral herniated disk, but the cardinal and earliest feature is sciatic pain on the affected side or on both sides. Associated findings include postural deformity (lumbar lordosis or scoliosis), paresthesia, hypoactive deep tendon reflexes in the involved leg, and dorsiflexor muscle weakness.

Meningitis

A positive Kernig’s sign usually occurs early with meningitis, along with fever and, possibly, chills. Other signs and symptoms of meningeal irritation include nuchal rigidity, hyperreflexia, Brudzinski’s sign, and opisthotonos. As intracranial pressure (ICP) increases, headache and vomiting may occur. In severe meningitis, the patient may experience stupor, coma, and seizures. Cranial nerve involvement may produce ocular palsies, facial weakness, deafness, and photophobia. An erythematous maculopapular rash may occur in viral meningitis; a purpuric rash may be seen in those with meningococcal meningitis.

Spinal cord tumor

Kernig’s sign can be elicited occasionally, but the earliest symptom is typically pain felt locally or along the spinal nerve, commonly in the leg. Associated findings include weakness or paralysis distal to the tumor, paresthesia, urine retention, urinary or fecal incontinence, and sexual dysfunction.

Subarachnoid hemorrhage

Kernig’s sign and Brudzinski’s sign can both be elicited within minutes after the initial bleed. The patient experiences a sudden onset of severe headache that begins in a localized area and then spreads, pupillary inequality, nuchal rigidity, and decreased level of consciousness. Photophobia, fever, nausea and vomiting, dizziness, and seizures are possible. Focal signs include hemiparesis or hemiplegia, aphasia, and sensory or vision disturbances. Increasing ICP may produce bradycardia, increased blood pressure, respiratory pattern change, and rapid progression to coma.

READ BOOK EXCERPT ONLINE »

Brudzinski's sign: Medical causes
(Signs & Symptoms: A 2-in-1 Reference for Nurses)

Meningitis

A positive Brudzinski’s sign can usually be elicited 24 hours after the onset of meningitis, a life-threatening disorder. Accompanying findings may include headache, a positive Kernig’s sign, nuchal rigidity, irritability or restlessness, deep stupor or coma, vertigo, fever (high or low, depending on the severity of the infection), chills, malaise, hyperalgesia, muscular hypotonia, opisthotonos, symmetrical deep tendon reflexes, papilledema, ocular and facial palsies, nausea and vomiting, photophobia, diplopia, and unequal, sluggish pupils. As ICP rises, arterial hypertension, bradycardia, widened pulse pressure, Cheyne-Stokes or Kussmaul’s respirations, and coma may develop.

Subarachnoid hemorrhage

Brudzinski’s sign may be elicited within minutes after initial bleeding in subarachnoid hemorrhage, another life-threatening disorder. Accompanying signs and symptoms include sudden onset of severe headache, nuchal rigidity, altered LOC, dizziness, photophobia, cranial nerve palsies (as evidenced by ptosis, pupil dilation, and limited extraocular muscle movement), nausea and vomiting, fever, and a positive Kernig’s sign. Focal signs — such as hemiparesis, vision disturbances, or aphasia — may also occur. As ICP rises, arterial hypertension, bradycardia, widened pulse pressure, Cheyne-Stokes or Kussmaul’s respirations, and coma may develop.

READ BOOK EXCERPT ONLINE »

Kernig's sign: Medical causes
(Signs & Symptoms: A 2-in-1 Reference for Nurses)

Lumbosacral herniated disk

A positive Kernig’s sign may be elicited in patients with a herniated disk, but the cardinal and earliest feature is sciatic pain on the affected side or on both sides. Associated findings include postural deformity (lumbar lordosis or scoliosis), paresthesia, hypoactive deep tendon reflexes in the involved leg, and dorsiflexor muscle weakness.

Meningitis

A positive Kernig’s sign usually occurs early with meningitis, along with fever and, possibly, chills. Other signs and symptoms of meningeal irritation include nuchal rigidity, hyperreflexia, Brudzinski’s sign, and opisthotonos. As intracranial pressure (ICP) increases, headache and vomiting may occur. In severe meningitis, the patient may experience stupor, coma, and seizures. Cranial nerve involvement may produce ocular palsies, facial weakness, deafness, and photophobia. An erythematous maculopapular rash may occur in viral meningitis; a purpuric rash may be seen in those with meningococcal meningitis.

Spinal cord tumor

Kernig’s sign can be elicited occasionally, but the earliest symptom of a spinal cord tumor is typically pain felt locally or along the spinal nerve, commonly in the leg. Associated findings include weakness or paralysis distal to the tumor, paresthesia, urine retention, urinary or fecal incontinence, and sexual dysfunction.

Subarachnoid hemorrhage

Kernig’s sign and Brudzinski’s sign can both be elicited within minutes after the initial bleed. The patient experiences a sudden onset of severe headache that begins in a localized area and then spreads, pupillary inequality, nuchal rigidity, and decreased level of consciousness. Photophobia, fever, nausea and vomiting, dizziness, and seizures are possible. Focal signs include hemiparesis or hemiplegia, aphasia, and sensory or visual disturbances. Increasing ICP may produce bradycardia, increased blood pressure, respiratory pattern change, and rapid progression to coma.

READ BOOK EXCERPT ONLINE »

Nuchal rigidity: Medical causes
(Signs & Symptoms: A 2-in-1 Reference for Nurses)

Cervical arthritis

With cervical arthritis, nuchal rigidity develops gradually. Initially, the patient may complain of neck stiffness in the early morning or after a period of inactivity. Stiffness then becomes increasingly severe and frequent. Pain on movement, especially with lateral motion or head turning, is common. Typically, arthritis also affects other joints, especially those in the hands.

Encephalitis

Encephalitis, a viral infection, may cause nuchal rigidity accompanied by other signs of meningeal irritation, such as positive Kernig’s and Brudzinski’s signs. Usually, nuchal rigidity appears abruptly and is preceded by headache, vomiting, and fever. The patient may display a rapidly decreasing LOC, progressing from lethargy to coma within 24 to 48 hours of onset. Associated features include seizures, ataxia, hemiparesis, nystagmus, and cranial nerve palsies, such as dysphagia and ptosis.

Meningitis

Nuchal rigidity is an early sign of meningitis and is accompanied by other signs of meningeal irritation — positive Kernig’s and Brudzinski’s signs, hyperreflexia and, possibly, opisthotonos. Other early features include fever with chills, headache, photophobia, and vomiting. Initially, the patient is confused and irritable; later, he may become stuporous and seizure-prone or may slip into coma. Cranial nerve involvement may cause ocular palsies, facial weakness, and hearing loss. An erythematous papular rash occurs in some forms of viral meningitis; a purpuric rash may occur in meningococcal meningitis.

Subarachnoid hemorrhage

Nuchal rigidity develops immediately after bleeding into the subarachnoid space. Examination may detect positive Kernig’s and Brudzinski’s signs. The patient may experience abrupt onset of severe headache, photophobia, fever, nausea and vomiting, dizziness, cranial nerve palsies, and focal neurologic signs, such as hemiparesis or hemiplegia. His LOC deteriorates rapidly, possibly progressing to coma. Signs of increased ICP, such as bradycardia and altered respirations, may also occur.

READ BOOK EXCERPT ONLINE »

Brudzinski's sign: Medical causes
(Nursing: Interpreting Signs and Symptoms)

Arthritis.With severe spinal arthritis, a positive Brudzinski's sign can occasionally be elicited. The patient may also report back pain (especially after weight bearing) and limited mobility.

Meningitis.A positive Brudzinski's sign can usually be elicited 24 hours after the onset of meningitis, a life-threatening disorder. Accompanying findings may include headache, a positive Kernig's sign, nuchal rigidity, irritability or restlessness, deep stupor or coma, vertigo, fever (high or low, depending on the severity of the infection), chills, malaise, hyperalgesia, muscular hypotonia, opisthotonos, symmetrical deep tendon reflexes, papilledema, ocular and facial palsies, nausea and vomiting, photophobia, diplopia, and unequal, sluggish pupils. As ICP rises, arterial hypertension, bradycardia, widened pulse pressure, Cheyne-Stokes or Kussmaul's respirations, and coma may develop.

Subarachnoid hemorrhage.Brudzinski's sign may be elicited within minutes after initial bleeding in subarachnoid hemorrhage, a life-threatening disorder. Accompanying signs and symptoms include the sudden onset of severe headache, nuchal rigidity, altered LOC, dizziness, photophobia, cranial nerve palsies (as evidenced by ptosis, pupil dilation, and limited extraocular muscle movement), nausea and vomiting, fever, and a positive Kernig's sign. Focal signs—such as hemiparesis, vision disturbances, or aphasia—may also occur. As ICP rises, arterial hypertension, bradycardia, widened pulse pressure, Cheyne-Stokes or Kussmaul's respirations, and coma may develop.

READ BOOK EXCERPT ONLINE »

Kernig's sign: Medical causes
(Nursing: Interpreting Signs and Symptoms)

Lumbosacral herniated disk. Kernig's sign may be elicited in patients with lumbosacral herniated disk, but the cardinal and earliest feature is sciatic pain on the affected side or on both sides. Associated findings include postural deformity (lumbar lordosis or scoliosis), paresthesia, hypoactive deep tendon reflexes in the involved leg, and dorsiflexor muscle weakness.

Meningitis. Kernig's sign usually occurs early with meningitis, along with a fever and, possibly, chills. Other signs and symptoms of meningeal irritation include nuchal rigidity, hyperreflexia, Brudzinski's sign, and opisthotonos. As intracranial pressure (ICP) increases, headache and vomiting may occur. In severe meningitis, the patient may experience stupor, coma, and seizures. Cranial nerve involvement may produce ocular palsies, facial weakness, deafness, and photophobia. An erythematous maculopapular rash may occur in viral meningitis; a purpuric rash may be seen in those with meningococcal meningitis.

Spinal cord tumor. Kernig's sign can be elicited occasionally, but the earliest symptom is typically pain felt locally or along the spinal nerve, commonly in the leg. Associated findings include weakness or paralysis distal to the tumor, paresthesia, urine retention, urinary or fecal incontinence, and sexual dysfunction.

Subarachnoid hemorrhage. Kernig's and Brudzinski's signs can be elicited within minutes after the initial bleed in subarachnoid hemorrhage. The patient experiences a sudden onset of a severe headache that begins in a localized area and then spreads, pupillary inequality, nuchal rigidity, and a decreased level of consciousness. Photophobia, a fever, nausea and vomiting, dizziness, and seizures are possible. Focal signs include hemiparesis or hemiplegia, aphasia, and sensory or vision disturbances. Increasing ICP may produce bradycardia, increased blood pressure, respiratory pattern change, and rapid progression to coma.

READ BOOK EXCERPT ONLINE »

Nuchal rigidity: Medical causes
(Nursing: Interpreting Signs and Symptoms)

Cervical arthritis.With cervical arthritis, nuchal rigidity develops gradually. Initially, the patient may complain of neck stiffness in the early morning or after a period of inactivity. Stiffness then becomes increasingly severe and frequent. Pain on movement, especially with lateral motion or head turning, is common. Typically, arthritis also affects other joints, especially those in the hands.

Encephalitis.Encephalitis is a viral infection that may cause nuchal rigidity accompanied by other signs of meningeal irritation, such as positive Kernig's and Brudzinski's signs. Usually, nuchal rigidity appears abruptly and is preceded by headache, vomiting, and fever. The patient may display rapidly decreasing LOC, progressing from lethargy to coma within 24 to 48 hours of onset. Associated features include seizures, ataxia, hemiparesis, nystagmus, and cranial nerve palsies, such as dysphagia and ptosis.

Listeriosis.If listeriosis spreads to the nervous system, meningitis may develop. Signs and symptoms include nuchal rigidity, fever, headache, change in LOC, myalgia, abdominal pain, nausea, vomiting, and diarrhea.

Meningitis.Nuchal rigidity is an early sign of meningitis and is accompanied by other signs of meningeal irritation—positive Kernig's and Brudzinski's signs, hyperreflexia and, possibly, opisthotonos. Other early features include fever with chills, headache, photophobia, and vomiting. Initially, the patient is confused and irritable; later, he may become stuporous and seizure-prone or may slip into a coma. Cranial nerve involvement may cause ocular palsies, facial weakness, and hearing loss. An erythematous papular rash occurs in some forms of viral meningitis; a purpuric rash may occur in meningococcal meningitis.

Subarachnoid hemorrhage.Nuchal rigidity develops immediately after bleeding into the subarachnoid space. Examination may detect positive Kernig's and Brudzinski's signs. The patient may experience an abrupt onset of a severe headache, photophobia, fever, nausea and vomiting, dizziness, cranial nerve palsies, and focal neurologic signs, such as hemiparesis or hemiplegia. His LOC deteriorates rapidly, possibly progressing to coma. Signs of increased ICP, such as bradycardia and altered respirations, may also occur.

READ BOOK EXCERPT ONLINE »

Encephalitis as a complication of other conditions:

Other conditions that might have Encephalitis as a complication may, potentially, be an underlying cause of Encephalitis. Our database lists the following as having Encephalitis as a complication of that condition:

Encephalitis as a symptom:

Conditions listing Encephalitis as a symptom may also be potential underlying causes of Encephalitis. Our database lists the following as having Encephalitis as a symptom of that condition:

Medical news summaries relating to Encephalitis:

The following medical news items are relevant to causes of Encephalitis:

Related information on causes of Encephalitis:

As with all medical conditions, there may be many causal factors. Further relevant information on causes of Encephalitis may be found in:


 » Next page: Risk Factors for Encephalitis

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