Hollyoaks Hollyoaks blog Welcome to our Hollyoaks blog. Over the coming months, we will be following Dee Dee's storyline in the Channel 4 soap and exploring encephalitis in more depth, featuring real-life stories as well as answering your questions. We hope to update the blog regularly going forward. If you have any questions you would like us to answer, please contact us. Friday, May 11 Maddi, like Dee Dee, was affected by autoimmune encephalitis at a very young age, sharing some of the same symptoms as her counterpart on Hollyoaks. Her mum, Tricia, has written about her daughter falling ill with Anti-NMDAR Encephalitis. It is a very interesting and well-written insight into the impact that the condition can have. Read her story Thursday, May 10 - Dee Dee is administered with her medication. Yazz confronts Tony and Diane about their complain against Misbah. Later, Diane decides to withdraw the complain after finding out what was wrong with Misbah. Watch the episode Wednesday, May 9 - Dee Dee is administered with her medication. Misbah is administering Dee Dee's medication but goes on to give her more than she should which could have killed her. Dianne decides she is going to make a formal complaint about Misbah but Tony disagrees. Watch the episode Our View When it comes to treatment for encephalitis, there are two aims - to treat the cause and to deal with the symptoms. Key facts about the treatment of encephalitis There are two main types of encephalitis: Infectious when inflammation is caused by an infection (virus, bacteria, parasite, fungus) and Autoimmune when inflammation is caused by the body’s own immune system acting inappropriately. Treatment has two aims: to treat the cause and to deal with the symptoms (e.g. seizures, agitation; excessive movements) When encephalitis is firstly suspected, treatment with a drug called acyclovir is started because herpes simplex virus encephalitis can be deadly without aciclovir. There are guidelines for the management of viral encephalitis. If autoimmune encephalitis is suspected, treatment with immune therapies is started. These therapies have the role to stop the immune system acting inappropriately. In addition, some patients are treated with other drugs such as rituximab and cyclophosphamide. Every patient is unique, and so there is their illness and the response to the treatment. Therefore, the treatment recommended by a doctor will be based upon each patient’s signs, symptoms and test results. Unfortunately, all medications which target the immune system, may come with potential side effects, especially infections. Factsheet on immunotherapies As autoimmune encephalitis is relatively new discovered, there are no definite guidelines for the management of this type of encephalitis. Research and training for professionals is crucial. Tuesday, May 8 - Dee Dee is diagnosed with encephalitis Diane and Tony are devastated when Dee Dee is diagnosed with encephalitis and she’s not responding to treatment. Watch the episode Our View Encephalitis (inflammation of the brain) is a complex condition which does not have a standard test for diagnosis. Key facts about the diagnosis of encephalitis Diagnosis is made by looking at the symptoms, the results of the tests and the response of the patient to the treatment. Analysing cerebrospinal fluid via a lumbar puncture is crucial to the diagnosis of encephalitis. A lumbar puncture should be performed as soon as possible. Other helpful tests are neuroimaging (magnetic resonance imaging MRI, electroencephalography EEG) and blood tests. All these tests are looking for signs of inflammation and the presence/absence of infection and antibodies. In autoimmune encephalitis CT scans of the body to look for tumours, which may be the cause of encephalitis, are also performed. Sometimes, the results of the tests are negative, but the patient is still very poorly. This can make family members very worried and confused. This is because encephalitis is a complicated condition. Some of these tests may need to be repeated before a definite diagnosis is made. Despite all these tests, in around 37-62%* patients, no cause of encephalitis can be found. Diagnosis tests are also very helpful in eliminating other diseases that have similar symptoms and signs as encephalitis. Understanding the history of the illness (especially regarding the changes in behaviour and personality, but also travel history) from the patient and their family members is very important in the initial consideration of the diagnosis of encephalitis. More information on encephalitis and diagnosis Information for Health Professionals Diagnosis of viral encephalitis Latest research on diagnosing autoimmune encephalitis *Granerod J , Ambrose HE , Davies NW et al. Causes of encephalitis and differences in their clinical presentations in England: a multicentre, population-based prospective study . Lancet Infect Dis 2010 ; 10 : 835 – 44 . Glaser CA , Gilliam S , Schnurr D et al. In search of encephalitis etiologies: diagnostic challenges in the California Encephalitis Project, 1998–2000 . Clin Infect Dis 2003 ; 36 : 731 – 42 .