TBE, Tick Borne Encephalitis

Clinic

• Asymptomatic (70-98%)
• Typical biphasic course (75%)
  1. Initial phase: Fever, Headache, Myalgia, Arthralgia, Fatigue, General malaise, Anorexia, Nausea
  2. Second phase:
     • Meningitis 50%
     • Meningoencephalitis 40%
     • Meningoencephalomyelitis 10%

Entities	Sign / Symptoms	Rubrics
Meningitis	High fever, Headache, Nausea , Vomiting, Photophobia (Common) Vertigo	Headache. Meningitis; aseptic Nausea , Vomiting,
Encephalitis	Impaired consciousness ranging from somnolence to stupor and, in rare cases, coma Personality changes, behavioral disorders Concentration / Cognitive function disturbances Very rarely focal or generalized seizures, delirium and psychosis develop.	White matter (Cerebral cortex) Anxiety Olfactory hallucination Concentration; impaired Aphasia Memory; loss of In coordination, Ataxia	Brain-Stem Emotional lability Altered Consciousness
Meningo Encephalo Myelitis	Flaccid paresis (Typical) Severe pain in the affected muscle groups Upper extremities are more often affected than the lower Proximal segments more frequently than the distal ones. Tongue fasciculations Tremor of extremities Respiratory muscles rather commonly require artificial ventilatory support. Involvement of the central portions of the brainstem and medulla oblongata. Myelitis is only very rarely as the only manifestation of TBE.	LMN Flaccid Paralysis Muscular atrophy Extremities Weakness/ Paresis Fasciculation Hemiplegia. Quadriplegia Tremor Spinal Paralysis Transverse myelitis Myelitis. Neuritis; radicular Paresthesia Local Autonomic Dysfunction Urine Incontinence Dysphagia
Seizure		Temporal lobe epilepsy Kozhevnikov epilepsy
Hemorrhage		Thrombocytopenia
		Face Paralysis
		Pneumonia. Heart failure Leukopenia. Leukocytosis

Remedies

1. CUPR, PHOS
2. Caust, Gels, Op, Plb, Sul, Bell
3. Hell, Cocc, Lach, Alum, Agar