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Encephalitis is a rare condition that is most often caused by viruses (viral encephalitis). It can also be caused by non-infectious diseases, such as systemic lupus erythematous and Behcet’s disease (an autoimmune disorder). The leading cause of severe encephalitis is the herpes simplex virus.

Other causes include enterovirus infections or mosquito-borne viruses; Eastern equine encephalitis (EEE); Western equine encephalitis (WEE); Venezuelan equine encephalitis (VEE); Japanese encephalitis; and Zika virus.

The very young and the elderly are more likely to have more severe encephalitis.

Exposure to viruses can occur through breathing in respiratory droplets from infected people, certain insect bites, and direct skin contact.

What are encephalitis symptoms and signs?
The signs and symptoms of encephalitis can range from very mild flu-like symptoms to potentially life-threatening events. Signs and symptoms of encephalitis include sudden fever, headache, vomiting, visual sensitivity to light, stiff neck and back, confusion, drowsiness, unsteady gait, irritability, loss of consciousness, poor responsiveness, seizures, muscle weakness, sudden severe dementia, and memory loss.

How do health care professionals diagnose encephalitis?
A health care professional diagnoses encephalitis after performing a thorough history and exam. The exam will incorporate special techniques to look for signs of inflammation of the membranes that surround the spinal cord and brain (meninges). The doctor will order specific tests to help determine the diagnosis.

Tests that evaluate individuals suspected of having encephalitis include cerebrospinal fluid analysis, brain scanning such as computerized tomography scan (CT or CAT scan)/ Magnetic resonance imaging (MRI) scan, and an evaluation of the blood for infection and the presence of bacteria.

The most common method of obtaining a sample of cerebrospinal fluid (or CSF) for examination is a spinal tap. A spinal tap, or lumbar puncture (LP), involves the insertion of a needle into the fluid within the spinal canal. The needle goes between the spine’s bony parts until it reaches the CSF. A medical professional then collects a small amount of fluid to send to the laboratory for an exam.

Evaluating the CSF is necessary for a definitive diagnosis of encephalitis and to decide on the best treatment options.

Abnormal spinal fluid results confirm the diagnosis and, in the event of an infection, by identifying the organism that caused the infection.

What is the treatment of encephalitis?
People require urgent treatment with antibiotics and/or antiviral medications if a physician suspects that person has encephalitis. Patients may need to take sedatives for irritability or restlessness. Doctors may administer other medications to decrease fever or treat headaches.

Prevention
Basic steps to avoid the spread of infections (handwashing, covering mouth when coughing, etc.) can help prevent encephalitis.

*Dr. Nwaoney is an epidemiologist, Chief Executive Officer (CEO) and Medical Director of Richie Hospital and El Shaddai Group.

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Headaches are one of the most common medical complaints; most people experience them at some point in their life. They can affect anyone regardless of age, race, and gender.

The World Health Organization (WHO) reports that almost half of all adults worldwide will experience a headache in any given year.

A headache can be a sign of stress or emotional distress, or it can result from a medical disorder, such as migraine or high blood pressure, anxiety, or depression. It can lead to other problems. People with chronic migraine headaches, for example, may find it hard to attend work or school regularly.

Headache causes

A headache can occur in any part of the head, on both sides of the head, or in just one location.

Headaches can radiate across the head from a central point or have a vise-like quality. They can be sharp, throbbing or dull, appear gradually or suddenly. They can last from less than an hour up to several days.

There are different ways to define headaches. The International Headache Society(IHS) categorize headaches as primary, when they are not caused by another condition, or secondary, when there is a further underlying cause.

Primary headaches

Primary headaches are stand-alone illnesses caused directly by the overactivity of, or problems with, structures in the head that are pain-sensitive.

This includes the blood vessels, muscles, and nerves of the head and neck. They may also result from changes in chemical activity in the brain.

Common primary headaches include migraines, cluster headaches, and tension headaches.

Secondary headaches

Secondary headaches are symptoms that happen when another condition stimulates the pain-sensitive nerves of the head. In other words, the headache symptoms can be attributed to another cause.

A wide range of different factors can cause secondary headaches.

These include:

  • alcohol-induced hangover
  • brain tumor
  • blood clots
  • bleeding in or around the brain
  • “brain freeze,” or ice-cream headaches
  • carbon monoxide poisoning
  • concussion
  • dehydration
  • glaucoma
  • teeth-grinding at night
  • influenza
  • overuse of pain medication, known as rebound headaches
  • panic attacks
  • stroke

As headaches can be a symptom of a serious condition, it is important to seek medical advice if they become more severe, regular, or persistent.

For example, if a headache is more painful and disruptive than previous headaches, worsens, or fails to improve with medication or is accompanied by other symptoms such as confusion, fever, sensory changes, and stiffness in the neck, a doctor should be contacted immediately.

Headache types

The symptoms of a headache can depend on the type.

Tension headaches

Tension headaches are the most common form of primary headache. Such headaches normally begin slowly and gradually in the middle of the day.

The person can feel:

  • as if they have a tight band around the head
  • a constant, dull ache on both sides
  • pain spread to or from the neck

Tension-type headaches can be either episodic or chronic. Episodic attacks are usually a few hours in duration, but can last for several days. Chronic headaches occur for 15 or more days a month for a period of at least 3 months.

Migraines

A migraine headache may cause a pulsating, throbbing pain usually only on one side of the head. The aching may be accompanied by:

  • blurred vision
  • light-headedness
  • nausea
  • sensory disturbances known as auras

Migraine is the second most common form of primary headache and can have a significant impact on the life of an individual. According to the WHO, migraine is the sixth highest cause of days lost due to disability worldwide. A migraine can last from a few hours to between 2 and 3 days.

Rebound headaches

Rebound or medication-overuse headaches stem from an excessive use of medication to treat headache symptoms. They are the most common cause of secondary headaches. They usually begin early in the day and persist throughout the day. They may improve with pain medication, but worsen when its effects wear off.

Along with the headache itself, rebound headaches can cause:

  • neck pain
  • restlessness
  • a feeling of nasal congestion
  • reduced sleep quality

Rebound headaches can cause a range of symptoms, and the pain can be different each day.

Cluster headaches

Cluster headaches usually last between 15 minutes and 3 hours, and they occur suddenly once per day up to eight times per day for a period of weeks to months. In between clusters, there may be no headache symptoms, and this headache-free period can last months to years.

The pain caused by cluster headaches is:

  • one-sided
  • severe
  • often described as sharp or burning
  • typically located in or around one eye

The affected area may become red and swollen, the eyelid may droop, and the nasal passage on the affected side may become stuffy and runny.

Thunderclap headaches

These are sudden, severe headaches that are often described as the “worst headache of my life.” They reach maximum intensity in less than one minute and last longer than 5 minutes.

A thunderclap headache is often secondary to life-threatening conditions, such as intracerebral hemmorhage, cerebral venous thrombosis, ruptured or unruptured aneurysms, reversible cerebral vasoconstriction syndrome (RVS), meningitis, and pituitary apoplexy. Therefore, people who experience these sudden, severe headaches should seek medical evaluation immediately.

Headache diagnosis and treatment

A doctor will usually be able to diagnose a particular type of headache through a description of the condition, the type of pain, and the timing and pattern of attacks. If the nature of the headache appears to be complex, tests may be carried out to eliminate more serious causes.

Further testing could include:

  • blood tests
  • X-rays
  • brain scans, such as CT and MRI

The most common ways of treating headaches are rest and pain relief medication. Generic pain relief medication is available over the counter (OTC), or doctors can prescribe preventative medication, such as tricyclic antidepressants, serotonin receptor agonists, anti-epileptic drugs, and beta-blockers.

It is important to follow the doctor’s advice because overusing pain relief medication can lead to rebound headaches. The treatment of rebound headaches involves the reducing or stopping pain relief medication. In extreme cases, a short hospital stay may be needed to manage withdrawal safely and effectively.

Headache relief and self-care

A number of steps can be taken to reduce the risk of headaches and to ease the pain if they do occur:

  1. Apply a heat pack or ice pack to your head or neck, but avoid extreme temperatures.
  2. Avoid stressors, where possible, and develop healthy coping strategies for unavoidable stress.
  3. Eat regular meals, taking care to maintain stable blood sugar.

A hot shower can help, although in one rare condition hot water exposure can trigger headaches. Exercising regularly and getting enough rest and regular sleep contributes to overall health and stress reduction.

Alternative headache treatments

[acupuncture for headache]
Acupuncture is an alternative therapy that may help relieve headaches.

Several alternative forms of treatment for headaches are also available, but it is important to consult a doctor before making any major changes or beginning any alternative forms of treatment.

Alternative approaches include:

  • acupuncture
  • cognitive behavior therapy
  • herbal and nutritional health products
  • hypnosis
  • meditation

Research has not provided evidence to confirm that all these methods work. Sometimes, a headache may result from a deficiency of a particular nutrient or nutrients, especially magnesium and certain B vitamins. Nutrient deficiencies can be due to a poor quality diet, underlying malabsorption issues, or other medical conditions.

The WHO points out that headaches are often not taken seriously because they are sporadic, most headaches do not lead to death, and they are not contagious.

They call for more resources to be allocated for the treatment of headache disorders, because of the huge health burden they represent.

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Is it just a headache?

Although a bad migraine might make you wish for the end of everything, headaches are not usually life threatening. However, a severe headache can signal something much more serious, requiring emergency attention such as stroke, aneurysm, and meningitis. These are not terribly common, but it’s worth watching for a headache that feels markedly different from normal—even if normal is agonizing. Here are three signs to watch for.

Neck pain and fever

A stiff neck and fever could be a sign of meningitis, an inflammation of the membranes surrounding the central nervous system, which can quickly become critical.

Nausea

Severe nausea or vomiting and any neuro-deficit (such as difficulty speaking or walking), which could be signs of a hemorrhagic stroke.

The worst headache ever

“The thing we’re taught to look for is someone claiming to have ‘the worst headache of their life,'” says Adam Wilkes, MD, an ER specialist at Lankenau Hospital in Wynnewood, Pa. “It may mean that they have an aneurysm in the brain that has begun to leak a little blood, but could turn into a catastrophic full bleed. And that can be life threatening.”

See a doctor

If you go to the emergency room, expect the doctors to perform a CT scan, which can reveal a bigger problem. “We always like to be bothered,” says Dr. Wilkes. “Let me decide if there’s a problem or not. I’d so much rather have people come in unnecessarily and reassure them and send them home, than miss something that could have helped saved their life.” For more information on headaches that may be emergencies, visit our A-Z Health Library.

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For the average new mom who desires to breastfeed her newborn, how to make enough breastmilk is the ultimate goal.

Despite what many might think is no big deal, a research published in peer-reviewed journal,Paediatric Study, reveals that as many as 92 percent of first-time mothers sometimes encounter challenges that may make it impossiblefor them to breastfeed their babies.

Apart from the struggle to ‘teach’ the baby how to correctly latch on to the breast, there are also concerns that a new mom may not be able to generate enough breast milk to feed her baby.

A Consultant Paediatrician, Dr. Abimbola Ogunnusi, says that ordinarily, nearly all women are capable of making adequate breast milk to meet their baby’s needs.

Consultant Gynaecologist, Dr. Dominic Emeka,however says that certain circumstances may make it hard for women to lactate enough milk to feed their newborns.

He explains that sometimes, the stress of delivery can make the breast milk to take time in coming; while stress and lack of good sleep may also affect how much breast milk a nursing mother makes.

He says there are many things that a new mom can do if she wants to lactate as necessary.

First, he says, is that many women make the mistake of latching the baby to only one breast more often than the other.

“When this happens regularly, the underused breast will gradually cease producing milk and it may dry up eventually.

“So, the best way is to switch breasts in-between feeding. When a baby slows down, just change him to the next breast. And, depending on how long the baby feeds, you can switch breasts twice, thus making your child to have a go at each breast twice at each feeding time.

“That way, both breasts will be stimulated to produce more milk,” Emeka counsels.

He advises nursing mothers to always examine their nipples. “This is because when nipples are sore, the mother willexperience pains when she breastfeeds.

“She may therefore want to avoid breastfeeding until the sore heals. Before she knows what, milk production will reduce,” the physician explains.

He also notes that the longer a child feeds on the breasts, the more they are stimulated to produce milk. He therefore urges new moms to feed their babies regularly.

He warns that in extreme cases where a new mom is not able to breastfeed, she should see the doctor.

“This is because it may be a manifestation of larger health problems such as a hormonal disorder, low or high thyroid level, past breast injury, or due to too much blood loss during or after delivery.

“All these should be brought to the notice of the physician,” Emeka warns.

Ogunnusi adds that if there is still a fragment of placenta that didn’t come out after delivery, it may prevent the production of breast milk; and the situation may remain so until it is expelled.

Again, experts say, certain medicines, such as the combined contraceptive pill, or a cold remedy that contains a decongestant like pseudoephedrine, can lead to cessation of lactation.

Ogunnusisays what you eat has a big impact on the quality and quantity of the breast milk.

Nutritionists counsel nursing moms to drink water regularly, as this helps in preventing dehydration, thus helping in making lactation easy.

According to Consultant Nutritionist, Dr. Tobi Lawrence, a nursing mother’s nutrition would determine how much milk she produces, and the quality.

He advises that new moms eat diets that will not only nurse them back to health, but which will also enable them to produce enough milk to meet their babies’ demands.

He counsels that eating foods that are rich in complex carbohydrates such as rice, whole-grain pasta and bread, beans and our regular carbohydrate foods such as amala, eba, fufu and such like are healthy when eaten moderately and with vegetable soups.

He adds that a food like Quaker oats is also good for building and maintaining milk supply.

Again, he says, fruits and vegetables are indispensable, as they are rich in vitamins, minerals, and fibre.

“Beta-carotene-rich vegetables such as carrotsalso improve milk production because of their iron contents,” the nutritionist says.

He also urges new moms to feast on nuts such as cashews because they enhance milk production.

Good old garlic also makes the list. It can be used to spice foods, whether cooked or in raw form. Experts say it has milk-boosting components that nursing mothers will find beneficial.

Finally, getting enough sleep will douse tension and reduce stress. Experts advice getting as much nightly sleep as possible, while also taking naps during the day when the baby is sleeping.

The bottom line: If you have problems with lactation, see the doctor.

PUNCH.