World Encephalitis Day | When a "cold" becomes fatal, beware of the encephalitis crisis behind it

February 22nd of every year is World Encephalitis Day. The author learned from the Department of Critical Care Medicine of Brain Diseases of Hunan Second People's Hospital (Provincial Brain Hospital) that when fever, cough, mental confusion and sudden convulsions occur at the same time, it may not be ordinary flu, but a deadly crisis hidden: severe encephalitis .

From cold to coma: the immune system's deadly mutiny

19-year-old Xiao Ma (pseudonym) initially thought he had the flu due to repeated low-grade fever, but 20 days later he suddenly had whole-body convulsions and fell into a coma.

The Department of Critical Care Medicine of the Second People's Hospital of Hunan Province (Provincial Brain Hospital) diagnosed that this "flu" was actually autoimmune encephalitis (AE) - the immune system mistook brain neurons for enemies, triggering a "civil war" in the nervous system. Not only will patients suddenly experience psychiatric symptoms such as a cliff-like decline in memory and paranoia, but they may also be in danger of life due to complications such as status epilepticus and cerebral edema.

Three deadly traps of encephalitis

1. Strong camouflage

The initial symptoms are highly similar to those of a cold: fever (82%), headache (76%), and fatigue (65%) are easily ignored. However, if the following "warning signs" are combined, you need to seek medical attention immediately: abnormal mental behavior (such as nonsense, sudden personality changes, etc.); short-term memory loss (such as forgetting what you just said); limb twitching or changes in consciousness.

2. Rapid progress

Viruses or autoimmune reactions can cause brain edema within 48 hours, leading to brain herniation. Data show that the mortality rate of patients with severe encephalitis who are not treated in time is as high as 40%, and 30-50% of the survivors have sequelae such as epilepsy and cognitive impairment.

3. Young people are at high risk

People aged 15-35 account for 60% of AE cases, and their active immune systems may "accidentally injure" the brain when fighting against viruses. According to data, about 60-70% of patients with severe encephalitis were misdiagnosed as "colds" or "mental illnesses" when they were first diagnosed.

Race against time: How the intensive care unit turned the tide

Xiao Ma's successful treatment was due to the four life-saving lines of the Department of Critical Care Medicine for Brain Diseases:

1. Precision sniping techniques

Through cerebrospinal fluid antibody testing (the gold standard for diagnosis) + magnetic resonance imaging, the inflammation area can be accurately located and the cause of the disease can be identified within 48 hours.

2. Multi-dimensional immune regulation

A combination therapy of "hormone shock + immunoglobulin + plasma exchange" is used to quickly eliminate abnormal antibodies that attack neurons.

3. All-weather brain function protection

Equipment such as intracranial pressure monitoring and video EEG provide real-time warning of cerebral edema and epileptic storm, and bedside CRRT (continuous renal replacement therapy) can quickly stabilize the internal environment and alleviate the inflammatory storm.

4. Early neurorehabilitation intervention

Cognitive training, intensive care rehabilitation and other treatments were initiated 72 hours after the condition stabilized, significantly reducing the incidence of sequelae.

Seize the "golden 72 hours": be alert to these symptoms

Zhou Gaoya, director of the Department of Critical Care Medicine for Brain Diseases at the Second People's Hospital of Hunan Province (Provincial Brain Hospital), reminds: When a cold patient has any of the following symptoms, he or she should immediately go to a hospital with neurological intensive care capabilities:

1) Body temperature > 39°C and confusion

2) The twitching lasts for more than 5 minutes

3) Hallucinations or aggressive behavior

4) Stiff neck and projectile vomiting

On the occasion of World Encephalitis Day, Director Zhou Gaoya reminded that encephalitis is not an "old age disease" and young people need to be more vigilant against the "defection" of the immune system. Every splitting headache from staying up late to work overtime and every "little cold" that you have to endure may become the last straw that breaks the camel's back for the nervous system. Timely identification of warning signals and selection of medical institutions with neurocritical care capabilities are the keys to rewriting the outcome of life and death. Let us work together to improve our understanding of encephalitis and protect our brain health.

Hunan Medical Chat Special Author: Chen Shengnan and Li Jing, Department of Critical Care Medicine for Brain Diseases, Hunan Second People's Hospital (Provincial Brain Hospital)

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(Edited by YT)