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Symptoms of tick-borne viral encephalitis
Last reviewed: 19.10.2021
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The incubation period for tick-borne encephalitis is from 7 to 21 days, an average of 10-14 days. The disease begins acutely, usually with a rise in body temperature to 39-40 ° C, the appearance of severe headache, chills, fever, weakness, nausea and vomiting. From the first day of illness, hyperemia of the face, vascular injection of sclera, photophobia, pain in the eyeballs, often in the limbs, lower back. The child is braked, sleepy. Meningeal symptoms appear quickly: rigidity of the occipital muscles, positive symptoms of Kernig and Brudzinsky. On the 2-3 th day of the disease there is an encephalitic syndrome with a disturbance of consciousness from a mild sopor to a deep cerebral coma, generalized convulsions up to the development of an epileptic status, sometimes there are signs of psychomotor agitation with delirium and hallucinations. Often observed tremor of hands, twitching of the muscles of the face and limbs. Muscle tone is lowered, reflexes are depressed.
Against the background of the clinical picture of diffuse encephalitis, some children may have signs of foci. Especially characteristic for tick-borne encephalitis is the lesion of the lower parts of the brain stem involving the IX, X, XI and XII nuclei of cranial nerves and the appearance of bulbar disorders: aphonia, swallowing, soft palate paresis, hypersalivation, followed by a violation of the rhythm of breathing and a drop in cardiovascular tone . When white matter of the brain is damaged, spastic paresis of the extremities may appear. Often, hemiparesis is accompanied by central paresis of the facial and sublingual nerves on the side of the lesion.
The manifestation of foci may be various hyperkinesis, which arise as a result of stimulation of the white matter of one of the cerebral hemispheres by a rapidly forming scar tissue.
With the involvement of the gray matter of the spinal cord in the pathological process, the clinical picture of the disease reveals a poliomyelitis syndrome with flaccid paralysis: the paresis of the muscles of the neck, limbs and trunk.
Cerebrospinal fluid in tick-borne encephalitis follows under increased pressure, clear, with mild lymphocytosis. The amount of protein is normal at first, and in the period of recovery is somewhat increased.
In the blood at the height of intoxication, moderate leukocytosis is observed with a shift to the left to stab neutrophils, increased ESR. In the period of spastic paralysis, changes in blood may be absent.