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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 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 antibiotic 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 the fever or treat headaches.

Prevention

Basic steps to avoid spread of infections (hand washing, 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.

Stroke is one of the leading causes of death and disability worldwide and in the United States, specifically. New research finds that excessive sleep considerably raises the risk of this cardiovascular problem.

Globally, 15 millionTrusted Source people experience a stroke each year. Almost 6 million of these people die as a result, and 5 million go on to live with a disability.

In the U.S., over 795,000Trusted Source people have a stroke each year.

The list of traditional risk factorsTrusted Source for stroke is long, ranging from elements of lifestyle, including smoking, to preexisting conditions, such as diabetes.

More recently, researchers have started exploring sleep duration as another potential risk factor. Some studiesTrusted Source have found that either too much or too little sleep can increase the risk of cardiovascular events, including stroke.

According to these findings, regular sleep deprivation and sleep for more than 7 hours per night are each associated with a higher risk of stroke.

Now, a study appearing in the journal Neurology finds an association between daytime naps, excessive sleep, and stroke risk.

Dr. Xiaomin Zhang, from Huazhong University of Science and Technology, in Wuhan, China, is the corresponding author of the paper that details this study.

85% higher risk in long sleepers, nappers

Dr. Zhang and the team collected information from 31,750 people in China. None of the participants — who were 62 years old, on average — had a history of stroke or any other serious health condition at the start of the study.

The participants answered questions about their sleeping patterns and napping habits, and the researchers clinically followed the group for an average of 6 years.

The team found that 8% of the participants were in the habit of taking naps that lasted longer than 90 minutes, and 24% reported sleeping for at least 9 hours each night.

Over the study period, there were 1,557 strokes among the participants. Those who slept for 9 or more hours per night were 23% more likely to experience a stroke than those who regularly slept only 7–8 hours each night.

People who got less than 7 hours of shuteye or 8–9 hours had no higher risk of stroke than those who slept 7–8 hours.

Importantly, people who both slept for longer than 9 hours and napped for more than 90 minutes per day had an 85% higher risk of stroke than those who slept and napped moderately.

Finally, sleep quality seemed to play a role — people who reported poor sleep quality were 29% more likely to have a stroke than those whose sleep quality was reportedly good.

These results continued to be significant after adjusting for potential confounders, such as hypertension, diabetes, and smoking.

“These results highlight the importance of moderate napping and sleeping duration and maintaining good sleep quality, especially in middle-age and older adults.”

Dr. Xiaomin Zhang

Study limitations and potential mechanisms

The researchers acknowledge some limitations to their work, as well as the fact that more research is necessary.

First, because the study was observational, it cannot prove causality. Second, the research did not account for sleep apnea or other sleep disorders that may have influenced the results.

Third, self-reported data is not as reliable as data recorded by researchers who observe participants’ sleep.

Finally, the results may only apply to older, healthy Chinese adults and not to other populations.

“More research is needed to understand how taking long naps and sleeping longer hours at night may be tied to an increased risk of stroke, but previous studies have shown that long nappers and sleepers have unfavorable changes in their cholesterol levels and increased waist circumferences, both of which are risk factors for stroke,” explains Dr. Zhang.

“In addition, long napping and sleeping may suggest an overall inactive lifestyle, which is also related to increased risk of stroke.”