Vol. 4, Issue 2 (2019)
Study of clinico-etiological profile of acute febrile encephalopathy
Author(s): Dr. Chandra Shekhar Rawat, Dr. TN Dubey, Dr. Rita Singh Saxena
Abstract: Background: The profile of febrile encephalopathy varies on the basis of different demographic and geographical characteristics of the study population. It is important to determine the etiologic spectrum of febrile encephalopathy syndrome, with an emphasis on the CNS infection by focusing on epidemiology and age groups. Aims and objectives: To study the clinical and etiological profile of patients presenting with Acute Febrile Encephalopathy and correlate it with lab parameter in various etiological categories. Materials and Methods: Three hundred and ninety eight patients were studied in the Medicine Department attached to the Gandhi Medical College Bhopal and affiliated Hamidia Hospital Bhopal, over a period of 12 months. After detailed history and clinical examination, patients were classified into six broad groups of categories as pyogenic meningitis (PM), acute viral encephalitis (AVE), cerebral malaria (CM), sepsis associated encephalopathy (SAE), enteric encephalopathy (EE) and tubercular meningitis (TBM). Results: Majority of the patients were diagnosed with CM (29.4%) followed by SAE (17.1%) and AVE (16.6%), PM (13.8%), TBM 913.6%) and EE (9.5%). AVE and CM were more prevalent in working age group while EE, TBM and PM were more prevalent in young age group subjects. Patients having fever, vomiting, serizers, fundus abnormality and hepatosplenomegaly can be suspected for having CM, PM and TBM as these symptoms were more prevalent among these patients. Seizers were more common among the patients with AVE and PM. Brain imaging (CT/MRI) evaluation revealed that Cerebral Oedema was most common among CM patients (66.7%), meningeal enhancement was mainly observed in PM (50.5%) and TBM patients (38.5%). EEG findings revealed that AVE (45%), CM (35%), PM (12.5%), SAE (1.2%) and TBM (6.2%) had generalized seizures respectively, whereas all patients affected with temporal lobe spikes were of AVE (100)]. Conclusion: Etiology of acute febrile encephalopathy is varied. Cerebral malaria was the most common cause of acute febrile encephalopathy from this region followed by Sepsis Associated Encephalopathy, Acute Viral Encephalitis, Pyogenic Meningitis and Tubercular Meningitis.