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What Causes Acute Meningoencephalitis?

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Posted on Mon, 4 Jan 2016
Question: Hello Doctor,

This is a follow up question to the previous set of questions related to hospitalization of nephew. He is still having seizures after 21 days of treatment though with somewhat less frequency of 2-3 days. I am attaching is current case summary providing all the necessary details. Any suggestions/opinion based on his current condition.
doctor
Answered by Dr. Diptanshu Das (1 hour later)
Brief Answer:
Newer anticonvulsants can be used. Dose adjustment of previous medicines required.

Detailed Answer:
Thanks for asking once again on HealthcareMagic. Your question has been posted on a common pool and I would try to answer your query. I have gone carefully through the case details of your nephew XXXXXXX and have also reviewed the previous thread.

Acute meningoencephalitis is a serious condition and in case of active autoimmune process is hard to treat. The treatment is supportive. Use of short course of steroids may be considered. Anticonvulsants need to be given religiously in time bound fashion and for prolonged duration. Newer antiepileptics like levetiracetam and lamotrigine along with proper dose modification may be considered if the present antiepileptics are providing inadequate relief. Talk to your treating physician as these are prescription medications and require careful consideration of the specific details before administering them.

Let me know if you wish to know anything specific and I would be happy to help.

Regards
Above answer was peer-reviewed by : Dr. Sonia Raina
doctor
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Follow up: Dr. Diptanshu Das (21 hours later)
Thank you doctor for response and checking all previous reports as well. Currently my nephew is being advised to take several medicines, I am attaching his prescription paper, please have a look. Are all these medicines required? What are the side effects of these medicines. As of now he didn't get any seizures since last 1-2 days. What should be future precautions in his case? Is there anything we can do to avoid side effects of medicines specially brain related (if any)? Please let me know your responses.
doctor
Answered by Dr. Diptanshu Das (4 hours later)
Brief Answer:
Your nephew needs to take a number of medicines regularly

Detailed Answer:
Thanks for asking back.
* Valproate is an important anticonvulsant which needs to be taken.
* Levera (levetiracetam) is the anticonvulsant I had suggested. Give it along.
* Lacotide (lacosamide) is another anticonvulsant. I am sure that your doctor has felt it justified adding it. Give it along.
* Oleptal DT (oxcarbazepine) - Another anticonvulsant. I am not sure if this too is needed.
* Tapamac - I am not sure about this.
* Prednisolone is a steroid in accordance to my suggestion.
* Shelcal is calcium supplementation. It is good to be given.
* Lanzol - medicine to reduce hyperacidity. Optional. To be given in case of stomach discomfort.
* Midacip - Very important. Needs to be given during a convulsion to stop the attack.

Do not bother about the side effects. All medicines can have side effects. Right now the utility of taking these is far more.

No specific precautions other than avoidance of triggers if any. Give the medicines religiously.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Diptanshu Das (21 hours later)
Thank you Doctor for providing detailed response on medicines. We came to know that my nephew's West Nile Virus(WNV) reports came positive. Upon reading about it, looks like there is no antibiotic for this virus. Is there any way to find out more about patients of severe/meningoencephalitis cases of WNV, Are there cases of meningoencephalitis caused by WNV where patient got completely recovered without any neurological impact?
doctor
Answered by Dr. Diptanshu Das (3 hours later)
Brief Answer:
Long term sequel depends upon degree of damage and scarring

Detailed Answer:
Thanks for writing back.

Viral infections do not respond to antibiotics and resolve on their own.
Whether there would be long term neurological impact depends upon the extent of damage and scarring caused. Chances are that with proper medication and follow up, he would be completely fine.
Please do nto panic.

Regards
Note: For further queries related to your child health, Talk to a Pediatrician. Click here to Book a Consultation.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Diptanshu Das

Pediatrician

Practicing since :2005

Answered : 3877 Questions

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What Causes Acute Meningoencephalitis?

Brief Answer: Newer anticonvulsants can be used. Dose adjustment of previous medicines required. Detailed Answer: Thanks for asking once again on HealthcareMagic. Your question has been posted on a common pool and I would try to answer your query. I have gone carefully through the case details of your nephew XXXXXXX and have also reviewed the previous thread. Acute meningoencephalitis is a serious condition and in case of active autoimmune process is hard to treat. The treatment is supportive. Use of short course of steroids may be considered. Anticonvulsants need to be given religiously in time bound fashion and for prolonged duration. Newer antiepileptics like levetiracetam and lamotrigine along with proper dose modification may be considered if the present antiepileptics are providing inadequate relief. Talk to your treating physician as these are prescription medications and require careful consideration of the specific details before administering them. Let me know if you wish to know anything specific and I would be happy to help. Regards