RBS, Rhabdo virus

It is a viral miasm

Entities

Encephalitis

• Hyperactivity, Agitation, Wild Delirium (Hydrophobia. Aeorophobia, Spitting of saliva. Barking. Biting), Delusions,  Rage
• Impaired cognition
• Personality change
• Coma, Confusion, Altered consciousness

Meningitis

• Headache
• Cervical rigidity

Laryngeal spasm

• Throat Spasm /Discomfort, Choking sensation,
• Making strange voices in throat
• Involuntary laryngeal spasm
• Hydrophobia, Choking Phobia
• Difficult swallowing; liquids. Impossible swallowing
• Agg from exposure to water

Autonomic stimulation

• Salivation: Abundant, viscid Saliva
• Lachrymation
• Sweating
• Mydriasis / Anisocoria
• Impaired temperature homeostasis
• Tachycardia
• Tachypnea. Hyperventilation, Short inspiration, Distress, Apnea
• Pilorection / Ejaculation; spontaneous. Priapism
• Ileus (Nausea. Vomiting.) + Diarrhea + Anorexia

Myocarditis

• Bradycardia
• Arrhythmia
• Congestive Heart Failure

GBS

• Ascending flaccid paralysis
• Quadriparesis, Paralysis
• Paresthesia
• Deep tendon reflex loss
• Impossible swallowing
• Arrhythmia

• Sphincter atony (Bladder)

• Fasciculation

• Diaphragm paralysis

Cranial nerve palsy

• Pharyngeal paralysis

Rigidity

• Muscular Spasms (Painful rigidity)
• Opisthotonous position

Seizure: Myoedema

GI bleeding

Hypotension

Sensitive to external stimuli: Sight and sound of water agg. Reflection of light in mirror agg. Light agg.

Tremor

Bladder atony

Constipation

Complication

• Coma
• ICP increasing
• Encephalopathy
• Death

Remedies

1. LYSS, STRAM
2. BELL
3. Nux-v, Lach, Cupr, Hyos, Phos, Cic
4. Tarent, Sul, Anac, Bufo, Hell, Op, Verat

Rabies is a viral disease that causes encephalitis in humans and other mammals. It was historically referred to as hydrophobia ("fear of water") due to the

Panic attacks when presented with liquids to drink.

Early symptoms can include fever and tingling at the site of exposure.

Following symptoms: Nausea, Vomiting, Violent movements, Uncontrolled excitement, Fear of water, Inability to move parts of the body, Confusion / Loss of consciousness.

Symptoms can include slight or partial paralysis, anxiety, insomnia, confusion, agitation, abnormal behavior, paranoia, terror, and hallucinations. The person may also have fear of water.

The symptoms eventually progress to delirium, and coma.

Rabies has also occasionally been referred to as hydrophobia ("fear of water") throughout its history. It refers to a set of symptoms in the later stages of an infection in which the person has difficulty swallowing, shows panic when presented with liquids to drink, and cannot quench their thirst. Any mammal infected with the virus may demonstrate hydrophobia.^{[failed verification]} Saliva production is greatly increased, and attempts to drink, or even the intention or suggestion of drinking, may cause excruciatingly painful spasms of the muscles in the throat and larynx. Since the infected individual cannot swallow saliva and water, the virus has a much higher chance of being transmitted, because it multiplies and accumulates in the salivary glands and is transmitted through biting. Hydrophobia is commonly associated with furious rabies, which affects 80% of rabies-infected people. This form of rabies is notorious for causing irrational aggression in the host, which aids in the spreading of the virus through animal bites. The remaining 20% may experience a paralytic form of rabies that is marked by muscle weakness, loss of sensation, and paralysis; this form of rabies does not usually cause fear of water.

...

Rabies virus antigen preferentially localizes in the spinal cord and brainstem and thalamus, basal ganglia

Serial electrophysiologic studies of peripheral nerve in furious rabies patients revealed a sub-clinical evidence of anterior horn cell dysfunction in the spinal cord [6,7]. These patients did not exhibit any demonstrable weakness of the arms and legs. It is only at the time when furious rabies patients become comatose that weakness of all limb musculatures can be demonstrated. In paralytic rabies patients, limb weakness is explained by peripheral nerve and not the anterior horn cell dysfunction [6,7]. This is also confirmed by prominent inflammation and demyelination in the peripheral nerve of these paralytic rabies patients [6-10].

These findings raised important questions why clinical weakness due to spinal cord dysfunction does not develop in rabies patients. Along with this "escape phenomenon" of rabies virus infected spinal cord, it is also intrigued that rabies patients do not have depressed consciousness during the most entire clinical course despite an enormous amount of rabies virus since the early stage in the brainstem and thalamus, structures which are crucial in maintaining alertness and form an integral part of reticular activating system.

Spinal cord motoneuron resists to cytolysis and apoptosis in spinal cord and anterior horn cell culture system with rabies virus infection [11]. In vivo, despite the massive infection of the spinal cord in infected rat neonates, only a few motoneurons were apoptotic. Moreover, axon of rabies infected motoneuron was able to elongate at a comparable rate in virus-infected and noninfected cultures indicating that metabolic activity was maintained in these infected cells. In contrast, a large proportion of hippocampus neurons were apoptotic shortly after infection. These suggest that spinal cord motoneurons survive rabies virus infection because the viral induction of apoptosis is delayed in these neurons.

Apoptosis or programmed cell death can be induced by multiple insults which proceeds through the mitochondrial pathway – mitochondrial outer membrane permeabilization (MOMP) in which cytochrome c appears to be a major inducer of the entire cascade though the activation of caspase-9 and -3 [12].

The objective of our study was to determine whether brainstem and spinal cord in rabies patients are lacking of either apoptosis or mitochondrial outer membrane permeabilization (MOMP) or both which, in turn, may explain this escape phenomenon. We also compared the degree of rabies virus infection and apoptosis and MOMP at various CNS regions of furious and paralytic rabies patients.

JE vs RBS (Common rubrics)

• Rigidity
• Altered consciousness, Disorientation, Delirium,
• Seizure, tremor
• GBS, paralysis
• Meningitis
• Cognition impaired, Behavior changed, Concentration difficult, Memory, Altered thought pattern, Mental retardation
• Psychosis, Hallucinations, Delusion
• Unequal pupils