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Saving Those Most at Risk with Encephalitis
Arun Venkatesan, M.D., Ph.D.
Assistant Professor of Neurology

Romergryko Geocadin, M.D.
Associate Professor
Department of Anesthesiology/Critical Care Medicine
Division of Neuroscience Critical Care

Encephalitis results from infection or inflammation of the brain.  Affected individuals can experience headaches, confusion, seizures, weakness, and language difficulties.  In severe cases, death can occur, while many survivors are left with significant physical and cognitive disability.  Despite the serious burden that encephalitis incurs on patients and society, few specific advances have been made in management and treatment in recent decades. In order to better understand the factors that contribute to death and disability in individuals with encephalitis, we examined patients admitted to the intensive care unit.  Our most notable finding was that several treatable conditions, including status epilepticus (continuous seizures), cerebral edema (brain swelling), and thrombocytopenia (low platelet counts), were strongly associated with death.  Thus, our study suggests that aggressive monitoring and treatment for ongoing seizure activity, brain swelling, and derangements in blood counts may decrease mortality and improve outcome in individuals with encephalitis.

This work is part of a larger program at the Johns Hopkins Encephalitis Center devoted to diagnosing and treating encephalitis. 
Other current research projects are aimed at:

  1. identifying new methodologies to diagnose autoimmune causes of encephalitis
  2. defining markers for prognosis and outcome in encephalitis, including electrical signatures in the brain
  3. developing novel treatments for status epilepticus and other complications of acute encephalitis
  4. establishing new paradigms for cognitive recovery after encephalitis. 

Moreover, the Venkatesan laboratory is focused on identifying new drug treatments to protect the nervous system from damage in the setting of inflammation.

Arun Venkatesan, M.D., Ph.D. is an assistant professor at the Johns Hopkins University School of Medicine, in the Department of Neurology, Division of Neuroimmunology and Neuroinfectious Diseases. He received his undergraduate degree in biomedical engineering from the University of California, Berkeley in 1994, followed by a  Ph.D. in microbiology and immunology and an M.D. from the University of California, Los Angeles.  He directs clinical activities and research at the Johns Hopkins Encephalitis Center, where he has developed a multidisciplinary program devoted to delineating pathogenesis and optimizing diagnosis and management of infectious and autoimmune encephalitis.  His laboratory research focuses on defining mechanisms of central nervous system axon injury in the setting of infection and neuroinflammation, with a goal towards developing axon protective and regenerative strategies.  He has received funding from the National Institutes of Health, Howard Hughes Medical Institute, National Multiple Sclerosis Society, and Maryland Stem Cell Research Fund.

Dr. Romergryko (Romer) Geocadin, M.D. is an associate professor at the Johns Hopkins School of Medicine in the Department of Anesthesiology/Critical Care Medicine Division of Neuroscience Critical Care. He received his training from The University of the East in Quezon City, Philippines, completed his residency at the New York University Medical Center, and his fellowship at the Johns Hopkins Hospital specializing in Neurological Critical Care. Dr. Geocadin is involved with numerous projects one of which seeks to study the changes in mental status and levels of consciousness in relation to encephalitis. His efforts were essential to the recent establishment of the Encephalitis Center at Hopkins. The big problem is the alternation in levels of consciousness from coma to seizures. Patients with encephalitis have altered levels of consciousness. In the best conditions, only ~40% have determinable etiology; the rest are unknown.
Learn more about Dr. Venkatesan and Dr. Geocadin

Additional information:

Learn more about the Johns Hopkins Encephalitis Center

Learn more about Encephalitis - Johns Hopkins Health Library

Listen to Dr Arun Venkatesan talk about the Johns Hopkins Encephalitis Center

Read "Conditions Most Likely to Kill Encephalitis Patients Identified"
Posted on Science Daily, Aug. 20th , 2013

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