American Medical Association Family Medical Guide - American Medical Association [437]
Most of the other viruses that cause encephalitis do not respond to treatment with medication. For these cases, treatment consists of relieving the symptoms and allowing the immune system to eliminate the virus. Your doctor may prescribe corticosteroid drugs to reduce the swelling in your brain from the inflammation. If the muscles that assist breathing are affected, you will be put on a ventilator. If swallowing is impaired, you may need to be fed intravenously (through a vein). In severe cases, recovery may be slow and incomplete and a person may need therapy to relearn basic skills such as speaking.
Polio
Polio (short for poliomyelitis) is a viral infection that affects muscle-controlling nerves in the brain and spinal cord. The virus, which is spread by contact with an infected person or by eating or drinking contaminated food or liquids, usually causes only a mild infection. Widespread, mandatory vaccination (see page 374) of children in developed countries (such as the United States) has almost eliminated the infection in those countries. A person who has had polio may, years later, experience muscle deterioration, pain, or weakness in previously affected muscles; this condition is called postpolio syndrome.
Polio Booster for Foreign Travel
If you or members of your family are going to travel to a country in which polio still occurs—such as many developing countries in Africa, the Middle East, and Asia—ask your doctor if you should have a polio booster before you leave.
Symptoms
The early symptoms of polio include headache, stomachache, sore throat, fever, and diarrhea. The symptoms may begin suddenly and last only a few days. In a small percentage of cases, polio invades the brain and develops into a severe infection, with pain and stiffness in the neck, back, and legs. In severe cases, muscles (including the muscles that control breathing) may become weak and cause paralysis or, sometimes, death.
Diagnosis
If you have recently traveled abroad or have not been vaccinated against polio and have symptoms of polio (such as fever and pain in your muscles, neck, and back), your doctor will take a sample of saliva from your throat or a stool sample to determine if the polio virus is the cause. He or she will also recommend a lumbar puncture (see page 693), in which a sample of cerebrospinal fluid (the liquid that surrounds the brain and spinal cord) is taken from the spinal canal and examined under a microscope to look for inflammation or the presence of infection-fighting white blood cells and proteins.
Treatment
There is no cure for polio. Most infections do not result in permanent damage. In people who are paralyzed from polio, physical therapy can help retain muscle function and limit further muscle damage. If breathing has been affected, a ventilator may be necessary to assist breathing. For people with postpolio syndrome, treatment may involve pain medication, physical therapy, and the use of a brace for parts of the body that are weakened, such as the legs.
Epidural Abscess
An epidural abscess (also called an extradural abscess) is a collection of pus in the space between the skull and the dura mater (the outermost of the three membranes that cover the brain and spinal cord). An epidural abscess is usually caused by a bacterial infection that has spread from a nearby infection such as an ear infection, sinusitis, or an infection in the bones of the skull or spine as the result of an injury or surgery. As the pus collects, it irritates surrounding tissues, causing pain. Inside the spinal cord, the pus can press on the cord and cause symptoms resembling those of a spinal cord tumor (see page 682). In rare cases, the bacteria produce toxins that can damage the dura mater.
Symptoms
The symptoms of an epidural abscess include headache, confusion, fever, chills, muscle weakness, or loss of sensation. Except for fever, symptoms may