Encephalitis

By | 2011-05-22

Definition and cause

Encephalitis is an inflammatory process of the brain that may or may not involve the meninges and / or the spinal cord. It is often caused by infections and immune-mediated processes, especially in pugs and Maltese dogs. Encephalitis occurs in both dogs and cats, and is commonly associated with the following causes: viral (canine distemper or feline viral diseases), bacterial, rickettsial, protozoan, and mycotic. There is some evidence of post-vaccinal encephalitis.

Medical therapy rationale, drug(s) of choice, and nutritional recommendations

Therapy is directed to the underlying causes along with symptomatic treatment such as the control of seizuring. Specific therapies are directed to the causative agent or process once the diagnosis is made. Common medical therapies include corticosteroids, antibiotics, antifungal agents, and mannitol to reduce edema.

Anticipated prognosis

The prognosis depends upon the underlying cause and the extent of the inflammatory process. The prognosis for infectious agents is generally fair if treated promptly. Viral and immune-mediated processes carry a more cautious prognosis. Post-vaccinal encephalitis can be mild but often causes permanent damage to the brain. Pug encephalitis is difficult to manage and is often fatal.

Integrative veterinary therapies

The underlying process is inflammatory and more commonly immune-mediated. The integrative approach, therefore, is to use nutrients, medicinal herbs, and combination homeopathics that have anti-inflammatory properties and that can help balance the immune system and quiet the exaggerated response. Clinicians should use any appropriate therapy in these cases. Integrative therapy using conventional medicine, nutrition, and biological agents may speed recovery, as well as improve patient comfort.

Nutrition

General considerations / rationale

After the cause of the encephalitis is identified, the clinician should include nutritional support for the brain and nervous system, as well as the immune glands and the liver along with indicated medical therapy.

Appropriate nutrients

Nutritional / gland therapies: Glandular brain, adrenal, thymus, spleen, and liver supply intrinsic nutrients, help protect the organs’ cells, reduce inflammation, and improve circulation to the brain (see Gland Therapy in site).

Phospholipids found in glandular brain are a source of unsaturated omega-3 fatty acids, which are now thought to play a vital role in the development and maintenance of the central nervous system. High concentrations of phosphatidyl choline and serine are found in brain tissue. Horrocks (1986) reported on the potential clinical use of these nutrients in chronic neurological conditions.

Betasitosterol: Betasitosterol is a plant-derived sterol that has anti-inflammatory properties similar to those of corticosteroids and aspirin. Sterols also have been proven to enhance immune function. They have been found to be able to enhance T-lymphocyte production and moderate B cell activity, thereby helping to balance the immune response and indirectly reducing the risk of an auto-immune reaction.

N,N-Dimethylglycine (DMG): DMG has been widely researched in both humans and animals. It has been found to increase energy and enhance immune function.

Chinese herbal medicine / acupuncture

General considerations / rationale

Encephalitis is caused by Heat and Wind accumulation in the Heart and Lung, which dries the body fluid into Phlegm. The Phlegm in turn moves upward to brain and blocks the meridians. The Heart houses the Shen, or Mind. Heat in the Heart can upset the Mind. The term “Phlegm blocking the meridians” translates into a clouding of the mind. In other words, in this condition the patient cannot interact properly with its environment. It also refers to the decrease of consciousness. Heat can also refer to the fevers seen in some cases. The term Wind refers to seizure activity.

Appropriate Chinese herbs

Centipede (Wu gong): Has antiseizure effects. It also inhibits various bacteria.

Curcuma (Yu jin): Contains curdione, which has sedative effects on the central nervous system.

Forsythia (Lian qiao): Decreases inflammation by decreasing capillary permeability, which contributes to its inhibitory effect on edema. It also decreases fever and pain. Forsythia has antiviral and antibacterial effects.

Grass-leaf sweet-flag root (Shi chang pu): Contains alpha-asarone, which has demonstrated an efficacy of approximately 85% in treating seizures in 90 people.

Gypsum (Shi gao): Has antipyretic effects. In one study of 200 patients with fevers, 90% experienced a significant reduction of temperature. It stimulates the phagocytic activity of macrophages and concurrently decreases inflammation.

Honeysuckle (Jin yin hua): Contains multiple compounds with antibacterial effects. The strongest among these are chlorogenic acid and isochlorogenic acid. In addition, honeysuckle has demonstrated anti-inflammatory and antipyretic effects in rabbits and mice.

Isatis leaves (Da qing ye): Has antibacterial and antiviral activity (Health and Epidemic Prevention Station of Lingling 1975). In addition to direct anti-pathogen effects, it enhances the immune system by increasing the phagocytic activity of macrophages and increasing serum lysozyme. Finally, isatis leaves have an anti-inflammatory action.

Licorice (Gan cao): Has glycyrrhizin and glycyrrhetinic acid, which have significant anti-inflammatory effects. They have approximately 10% of the corticosteroid activity of cortisol and can help prevent the formation of granulomas. Licorice has an analgesic effect. It also has demonstrated both antibacterial and antiviral effects.

Lophatherum (Zhu ye): Decreases fevers. It is as effective as phenacetin. It also has diuretic effects, which may help decrease cerebral edema.

Red peony (Chi shao): Contains paeoniflorin, a compound that has demonstrated antiseizure and sedative effects in animals.

Saussurea (Mu xiang): Has demonstrated antibacterial effects against several strains of bacteria.

Scorpion (Quan xie): Has been shown experimentally to control caffeine- or megimide-induced seizures in mice. A similar study of induced seizures in rats showed a decrease in severity, duration, and recurrence rates.

Silkworm (Jiang can): Has been proven effective at decreasing seizure activity in mice with experimentally induced seizures. In one trial, 77% of humans with epilepsy who were treated with Jiang can responded well. It was shown to have synergistic activity with phenobarbitol in mice. It is especially efficacious in cases of pyrexia-induced seizures. As an added benefit, it has been shown to inhibit several strains of bacteria.

Uncaria (Gou teng): Has been shown to prevent seizures in animals.

Acupuncture

There are few studies involving the use of acupuncture for encephalitis per se. Schoen (1991) postulated that it would be helpful in cases of encephalitis by decreasing inflammation and preventing muscle spasms. It helps alleviate seizures, possibly by causing the release of serotonin and GABA.

Homotoxicology

General considerations / rationale

Acute bacterial encephalitis represents an Inflammation Phase condition. Parasitic encephalitides are found in the Deposition Phase, while viral conditions are categorized as Impregnation Phase homotoxicoses. Most other inflammatory conditions are Impregnation or Degeneration phase disease manifestations. Such conditions can undergo rapid progressive vicariation to the Degeneration Phase.

Treatment involves supporting the immune system in its efforts to eliminate pathogens and associated homotoxins, as well as controlling swelling and pain to minimize damage to the delicate central nervous system. Moderate fevers help to remove homotoxins. The overuse of nonsteroidal antipyretics is undesirable from a biological therapy viewpoint.

Appropriate homotoxicology formulas

No veterinary studies exist on the use of antihomotoxic agents in encephalitis and meningitis, but Reckeweg developed protocols for human patients that can be applied to veterinary patients when biological therapy is desired. Appropriate remedies for consideration include:

Aconitum homaccord: Aconitum (also common to Barijodeel, Bryaconeel, Cerebrum compositum, Echinacea compositum, Gripp-Heel, Pectus-Heel, Rbododendroneel, Spascupreel, Strophanthus compositum, Traumeel, BHI-Cbamomilla Complex, BHI-FluPlus, BHI-Injury, and BHI-Spasm-Pain) is the main remedy. It is one of the most important homeopathic fever remedies, especially when the skin is hot, there is alternating fever and chills, and there is possible hyperthermia and paresthesia. Often, the patient exhibits great anxiety and a rapid, tense pulse that is strong and possibly dysrhythmia. Low potencies are normally given in pyrexia and organic complaints, catarrhs, neuralgic symptoms with paresthesia, hyperthermia, and encephalitis with very high temperatures (e.g., post-vaccinal encephalitis or meningoencephalitis.

Aesculus compositum: Helps to improve circulation following stroke or reduced cerebral circulation (Aesculus hippocastanum and Secale cornutum). Areteria suis supports the arteries. Solanum nigrum further supports cerebral function, particularly in cases with confusion, epileptic seizures, or disorientation. Several other agents support homotoxin removal and improve vessel stability. This remedy also contains Baptisia, which is also found in Arnica-Heel, Atropinum compositum, Echinacea compositum, Populus bomaccord, and Solidago compositum. It has indications in typhoid fevers, sepsis, and septic sore throat, as well as encephalitis and meningitis with states of confusion. It should be given intercurrently in all septic fevers.

Apis mellifica, a central component of several other remedies such as Apis compositum, Belladonna bomaccord, Apis bomaccord, Arnica-Heel, Crurobeel, Galium-Heel, and Populus compositum, is also included. There is also a certain oversensitivity to touch and frequently to any jarring, so that the patient yells out at the slightest bump. This may occur in meningeal irritation. In the latter, regarding human patients, such a typical penetrating scream (known as the “cri encephalique”) may begin with no apparent cause. Thus, Apis is a remedy that is frequently indicated in inflammatory conditions of the serous membranes, the meninges, the synovial membranes, or the mucous membranes.

Apis bomaccord: Generally useful in edema, but also in cerebral sensitivity. May assist cardiac-induced cerebral weakness through Scilla, Apisinum, and Apis mellifica. See Aesculus compositum, above.

Arsuraneel: Used for patients that do not respond to initial therapy. This formula may move them into a recovery phase through stimulation of the general defenses. It is useful in cases with seizures, anxiety feeling worse at night, paresis, and muscular disability.

Belladonna bomaccord: With an affinity for the central nervous system, Belladonna is useful in patients who manifest seizures and scream out at night. Violent delirium is characteristic of Belladonna, above all in fever. Belladonna’s typical action on the eyes is also well known, It is used for cramps in the muscles of the eyes and eyelids, and enlargement of the pupils, particularly in an inflammatory or irritative condition of the conjunctiva with great photophobia, epiphora, and pain. Belladonna is indicated in incipient boils; tonsillitis; surface inflammations such as erysipelas, conjunctivitis, and scarlet fever; otitis; cholangitis; meningitis; and other inflammatory affections. A delirious state occurs with a violent rise in temperature with considerably raised sensitivity of all the senses and a disproportionate sensitivity to touch, noises, light, cold air (especially draughts and jarring) as can be the case in meningitis. Along with nasal catarrhs, there may be catarrhs of the larynx and trachea, with slight mucus, accompanied a typical cough that is dry, rough, and barking, with hoarseness. In the digestive organs, Belladonna affects acute gastric catarrhs.

Bryaconeel: Treats neuralgia, serous membrane inflammation such as meningitis (Bryonia cretica), acute feverish conditions, and influenza-like signs. Contains Phosphorus to support parenchymatous organs such as the lung and liver. Moderates severe or overaggressive vicariations. Used in meningitis in cases that do not respond to primary therapy.

Cerebrum compositum: Supports cerebral tissue, stem cells, and vessels (Cerebrum suis, Placenta suis, and Arnica montana). Cerebrum suis is indicated in states of mental exhaustion and disturbances in development. Symptoms include functional weakness, circulatory disturbances of the brain, progressive paralysis (retrospective treatment), paraplegia, arteriosclerotic dementia, encephalomalacia, memory loss, and forgetfulness (Selenium, Thuja occidentalis, Acidum phosphoricum, Man-ganum phospohoricum, Semecarpus anacardium, Ambra grisea, Conium maculatum, Medorrhinum-Nosode). Supports cerebral function and vascular structures (Kalium phophoricum). Treats vertigo, stupor, and headache (Gelsemium sempervirens, Kalium bichromicum, Ruta graveolens), anxiety (Aconitum napellus), and exhaustion (China, Amarita cocculus). Supports capillary and other circulation, as well as lymph (Aesculus hippocastanum) and enzyme systems and difficulty sleeping (Hyoscyamus niger).

Coenzyme compositum: Supports energy production through enzyme induction and repair, and is useful in repairing damage to enzyme systems of metabolism and following administration of drugs injurious to metabolism. Phase remedy in Degeneration and Dedifferentiation phases.

Crurobeel: Has strong connective tissue effects and is useful in difficult cases or those with strong vicariation signs.

Echinacea compositum: Contains Zincum metallicum (also in Discus compositum, BHI-FluPlus, etc.) Zincum metallicum is a great nerve remedy, exerting a fundamental action on the brain and the autonomic centers and the sympathetic and the parasympathetic nervous systems. Symptoms of cerebral irritation occur after vaccination and when there is a threat of viral encephalitis. In these cases, Zincum metallicum, together with other medicaments which provoke a regressive vicariation, is able to release the homotoxins from the nervous system and break them down by way of the vaccination pustules, which once more become inflamed. Similar action has been known in Sulphur and Cuprum. In particular, these effects of reactivating blocked enzyme systems have often been described with reference to Sulphur. Chronic nerve pains and muscular twitching, as well as a general nervousness and hypersensitivity and high degree of excitability with emaciation, exhaustion, and paralytic weakness, may also indicated a need for Zincum. These conditions may proceed to the point of complete paralysis or hemiparesis with twitching, tremors, and weakness, as well as spasmodic conditions, neuralgia, and diseases that afflict the spine, brain, and spinal cord.

Engystol N: Has antiviral effects through immunostimulation.

Galium-Heel: Phase remedy in matrix and cellular phases. Provides powerful support of the immune system (Echinacea augustifolia). Assists in drainage of cell and matrix, is supportive of renal tubular function, and decreases swelling and edema (Apis mellifica, Galium aparine, and Galium mollugo). It is a critical component in the deep detoxification formula. Doses should be administered with regard to clinical condition and response, with the dose reduced if strong reactions are noted.

Gelsemium homaccord: Treats neuralgia and nerve pain, headache, and posterior weakness. Commonly required in aging, large-breed dogs.

Glyoxal compositum: Provides mitochondrial repair of damaged enzyme systems in Degeneration and Dediffer-entiation phase disorders.

Lymphomyosot: Used after cortisone therapy and mesenchymal purging in chronic disease states.

Placenta compositum: Supports hypophysis after cortisone therapy. Contains sulfur to support enzyme and metabolic repair. Regenerative of hypophyseal-adrenal axis. Repairs vascular structures and is used intermittently in endocrine disorders.

Secale compositum: The principle remedy (also found in Aesculus compositum, Arsuraneel, Circuloheel, Discus compositum, Placenta compositum, Secale [also known as Arteria-Heel], Syzygium compositum, BHI-Headacbe II, BHI-Migraine, and BHI-Varicose). Symptoms of meningitis may occur, with stiffness of the neck, muscular weakness, and periodic muscular pain with spasm and heaviness of the limbs and drawing and jerking pains. There also may be cramps, twitching and trembling of the limbs, or rigidity and stiffness of the limbs and joints.

Solidago compositum: Deposition Phase remedy needed to remove debris from the matrix after regressive vicaria-tion begins. Contains Coxsackie Virus Nosode with indications that include abacterial meningitis and headache, possibly including pareses.

Spigelon: Helpful for symptoms of headache, cerebral conditions with inflammation, and weakness of connective tissues.

Thyroidea compositum: Provides matrix drainage and repair of autoregulation. Contains low levels of thyroid, pineal, spleen, bone marrow, umbilical cord, and liver to support glandular function and repair. Galium aparine drains matrix and cellular components. Cortisonum aceticum, in low potency, assists in repairing damage from excess levels of cortisone. Precursors and Krebs cycle constituents promote energy metabolism through the Michaelis-Menten law of enzyme activity. Pulsatilla and Sulfur assist in regulation rigidity-type situations. Part of the deep detoxification formula.

Tonsilla compositum: Main antihomotoxic drug for repairing chronic diseases involving endocrine disorders. Supports a wide number of tissues including tonsil, lymph node, bone marrow, umbilical cord (stem cell precursors), spleen, hypothalamus, liver, embryo, and adrenal cortex. Contains Cortisonum aceticum and thyroid hormone in nanodilutions. Also contains Psorinum for deep constitutional, lack of reaction cases. Degeneration phase agent.

Ubichinon compositum: Provides mitochondrial repair of energy production mechanisms. Used in chronic diseases and iatrogenic injury to mitochondria from antibiotic therapy. Part of deep detoxification formula.

Authors’ suggested protocols

Nutrition

Brain / nerve support: 1 tablet for 25 pounds of body weight BID.

Immune support formula: One-half tablet for each 25 pounds of body weight BID.

Liver support formula: One-half tablet for each 25 pounds of body weight SID.

Betathyme: 1 capsule for each 35 pounds of body weight BID (maximum, 2 capsules BID).

DMG: Liquid — One-half ml per 25 pounds of body weight (maximum, 2 mis); tablets — 125 mg to 1 tablet for every 40 pounds of body weight (maximum, 3 tablets).

Chinese herbal medicine

Formula H90 Encephalitis: 1 capsule per 10 to 20 pounds twice daily. It can be used in both acute and chronic encephalitis and is especially effective in cases with seizures. In addition to the herbs discussed above, H90 Encephalitis also contains arisaema / bile (Dan nan xing), orange peel (Ju hong), pinellia (Ban xia), and salvia (Dan shen), which increase the efficacy of the formula.

This formula can be combined with any Western therapy as needed (i.e., anticonvulsants, antibiotics, anti-inflammatories). Some acupuncture points to consider include PC6, SP6, PC7, ST40, CV26, GV14, and KI3 (Handbook of traditional Chinese medicine Practitioners).

Homotoxicology (Dose: 10 drops PO for 50-pound dog; 5 drops PO for small dog or cat) According to Reckeweg, the following protocol is useful. Note that it has not been tested in animals.

Initial therapy: Belladonna homaccord and Apis homaccord mixed together and used orally TID. In viral issues, give Engystol N by injection or orally daily. In bacterial infections, consider Echinacea compositum given daily by injection (the initial dose is often given I.V., followed by sub-q dosing, often in the manner of an auto-sanguis injection). Spigelon given daily by injection or orally if there are signs of headache. Aesculus compositum and Echinacea comp forte, BID to TID orally.

In refractory cases that do not respond to initial therapy after 1 to 2 days: Cruroheel-S, Arsuraneel, and Bryaconeel mixed together and taken orally every 15 to 30 minutes. Aesculus compositum given in massive initial doses every 5 to 10 minutes and then TID orally as an aid to circulatory issues.

Following improvement: Cerebrum compositum, Placenta compositum, and Tonsilla compositum to improve cerebral, vascular, and lymphatic / immune status. Initially given by injection, then followed by oral dosing either together or on alternate days in succession twice weekly.

Product sources

Nutrition

Brain / nerve, immune, and liver support formulas: Animal Nutrition Technologies. Alternatives: Immune system and Hepatic support — Standard Process Veterinary Formulas; Hepagen — Thorne Veterinary Products; Immuno and Hepato Support — Rx Vitamins for Pets.

Betathyme: Best for Your Pets; Moducare; Thorne Veterinary Products.

DMG: Vetri Science.

Chinese herbal medicine

Formula H90 Encephalitis: Natural Solutions, Inc.

Homotoxicology

BHI / Heel Corporation