What are the symptoms of encephalitis. How is encephalitis diagnosed. What causes encephalitis. How is encephalitis treated. Can encephalitis be prevented. What are the long-term effects of encephalitis. How does encephalitis differ from meningitis.

Understanding Encephalitis: A Serious Brain Inflammation

Encephalitis is a rare but potentially life-threatening condition characterized by inflammation of the brain tissue. This serious neurological disorder can affect individuals of any age, though the very young and elderly are particularly vulnerable. Prompt recognition and treatment are crucial for improving outcomes and minimizing long-term complications.

What exactly is encephalitis?

Encephalitis refers to inflammation of the brain parenchyma, often accompanied by inflammation of the meninges (meningoencephalitis). This condition can be caused by various factors, including viral infections, autoimmune responses, and rarely, bacterial or fungal infections. The inflammation can lead to brain swelling, potentially causing severe neurological symptoms and complications.

Recognizing the Symptoms of Encephalitis

The symptoms of encephalitis can vary in severity and onset, ranging from mild flu-like symptoms to severe neurological deficits. Early recognition of these symptoms is crucial for timely intervention.

What are the initial symptoms of encephalitis?

Encephalitis often begins with flu-like symptoms, including:

• High fever
• Headache
• Fatigue
• Muscle aches
• Nausea and vomiting

What are the more serious symptoms that may develop?

As the condition progresses, more severe symptoms can emerge, typically over hours to days:

• Confusion or disorientation
• Seizures or fits
• Changes in personality and behavior
• Difficulty speaking or finding words
• Weakness or loss of movement in certain parts of the body
• Loss of consciousness
• Sensitivity to light
• Hallucinations
• Memory problems

It’s important to note that these symptoms can vary depending on the specific cause of encephalitis and the areas of the brain affected. In infants and young children, symptoms may also include:

• Bulging in the soft spots (fontanelles) of the skull
• Nausea and vomiting
• Body stiffness
• Irritability or poor feeding

Unraveling the Causes of Encephalitis

Understanding the underlying causes of encephalitis is crucial for effective treatment and prevention strategies. While the exact cause isn’t always identifiable, several factors have been associated with this condition.

What are the primary causes of encephalitis?

The most common causes of encephalitis include:

1. Viral infections: Viruses are the leading cause of encephalitis. Common culprits include:
   • Herpes simplex virus (HSV) types 1 and 2
   • Varicella-zoster virus (causes chickenpox and shingles)
   • Enteroviruses
   • Arboviruses (transmitted by mosquitoes or ticks)
   • Rabies virus
2. Autoimmune encephalitis: In some cases, the body’s immune system mistakenly attacks brain tissue, causing inflammation.
3. Post-infectious encephalitis: This can occur as a complication following viral infections like measles, mumps, or rubella.
4. Bacterial or fungal infections: Although rare, these can also lead to encephalitis, especially in individuals with weakened immune systems.

How do these causes lead to brain inflammation?

In viral encephalitis, the virus enters the bloodstream and crosses the blood-brain barrier, directly infecting brain tissue. This triggers an immune response, leading to inflammation. In autoimmune encephalitis, antibodies produced by the immune system mistakenly target brain cells, causing inflammation and neurological symptoms.

Diagnosing Encephalitis: A Multi-Faceted Approach

Accurate and timely diagnosis of encephalitis is crucial for implementing appropriate treatment strategies. Given the potentially severe consequences of the condition, a comprehensive diagnostic approach is typically employed.

What methods are used to diagnose encephalitis?

Diagnosis of encephalitis typically involves a combination of the following:

1. Medical history and physical examination: The physician will inquire about symptoms, recent illnesses, travel history, and conduct a thorough neurological exam.
2. Neuroimaging studies:
   • Magnetic Resonance Imaging (MRI): Provides detailed images of the brain to detect inflammation and rule out other conditions.
   • Computed Tomography (CT) scan: May be used initially, especially in emergency situations.
3. Lumbar puncture (spinal tap): Analysis of cerebrospinal fluid can reveal signs of infection or inflammation.
4. Electroencephalogram (EEG): Measures electrical activity in the brain, which can be altered in encephalitis.
5. Blood tests: To check for signs of infection, autoimmune conditions, or other underlying health issues.
6. Polymerase Chain Reaction (PCR) testing: Can detect viral genetic material in cerebrospinal fluid or blood.
7. Brain biopsy: In rare cases, a small sample of brain tissue may be required for definitive diagnosis.

Why is rapid diagnosis crucial in encephalitis?

Prompt diagnosis of encephalitis is essential because:

• Early treatment can significantly improve outcomes and reduce the risk of long-term complications.
• Certain causes, such as herpes simplex encephalitis, require immediate, specific antiviral treatment.
• Rapid identification of the cause can help prevent spread in cases of infectious encephalitis.
• Early intervention may prevent severe brain damage and associated neurological deficits.

Treatment Strategies for Encephalitis

The treatment of encephalitis requires a multidisciplinary approach, often in a hospital setting. The specific treatment plan depends on the underlying cause and the severity of symptoms.

What are the primary treatment approaches for encephalitis?

Treatment strategies for encephalitis may include:

1. Antiviral medications: For viral encephalitis, especially those caused by herpes simplex virus or varicella-zoster virus. Common antivirals include acyclovir and ganciclovir.
2. Immunosuppressive therapies: In cases of autoimmune encephalitis, medications to suppress the immune response may be necessary. These can include corticosteroids, intravenous immunoglobulin, or plasma exchange.
3. Supportive care: This is crucial and may involve:
   • Intravenous fluids to maintain hydration and electrolyte balance
   • Anti-epileptic drugs to control seizures
   • Pain relievers and fever reducers
   • Mechanical ventilation if breathing is compromised
4. Antibiotics or antifungal medications: If a bacterial or fungal cause is suspected or confirmed.
5. Management of intracranial pressure: In severe cases, measures to reduce brain swelling may be necessary, including medications or surgical interventions.

How long does treatment typically last?

The duration of treatment can vary significantly depending on the severity of the condition and the individual’s response. Some patients may require only a few days of hospitalization, while others might need weeks or even months of intensive care and rehabilitation.

Long-Term Outlook and Complications of Encephalitis

The prognosis for individuals with encephalitis can vary widely, ranging from full recovery to significant long-term neurological deficits. Understanding potential complications and long-term effects is crucial for patients and caregivers.

What are the potential long-term effects of encephalitis?

Long-term complications of encephalitis may include:

• Memory problems and cognitive impairment
• Personality changes
• Epilepsy or recurrent seizures
• Physical disabilities, such as weakness or paralysis
• Speech and language difficulties
• Balance and coordination problems
• Hearing or vision defects
• Emotional and behavioral changes
• Fatigue and sleep disorders

What factors influence the long-term prognosis?

Several factors can affect the long-term outlook for encephalitis patients:

• The specific cause of encephalitis
• The severity and duration of inflammation
• The areas of the brain affected
• The age and overall health of the patient
• How quickly treatment was initiated
• The individual’s response to treatment

It’s important to note that many patients do make significant recoveries, especially with early treatment and comprehensive rehabilitation. However, the recovery process can be lengthy and may require ongoing support and therapy.

Preventing Encephalitis: Strategies and Challenges

While not all cases of encephalitis can be prevented, there are several strategies that can reduce the risk of developing this serious condition. Understanding these preventive measures is crucial for public health efforts and individual protection.

What are the key strategies for preventing encephalitis?

Prevention strategies for encephalitis include:

1. Vaccination: Several vaccines can protect against viruses that may cause encephalitis:
   • Measles, Mumps, and Rubella (MMR) vaccine
   • Japanese encephalitis vaccine for travelers to certain Asian countries
   • Tick-borne encephalitis vaccine for those living in or traveling to affected areas
   • Rabies vaccination for high-risk individuals or travelers to endemic areas
2. Protection against insect bites: This is crucial for preventing arbovirus-related encephalitis:
   • Use insect repellents containing DEET or picaridin
   • Wear long-sleeved shirts and long pants when outdoors
   • Use bed nets in areas with a high prevalence of mosquito-borne diseases
   • Eliminate standing water around homes to reduce mosquito breeding sites
3. Practicing good hygiene: This can help prevent the spread of viruses that may lead to encephalitis:
   • Frequent handwashing
   • Avoiding close contact with individuals who have infectious illnesses
   • Covering mouth and nose when coughing or sneezing
4. Maintaining a healthy immune system: A robust immune system can help fight off infections that might lead to encephalitis:
   • Eating a balanced diet
   • Getting adequate sleep
   • Managing stress
   • Exercising regularly

Are there any challenges in preventing encephalitis?

Despite these preventive measures, several challenges remain in the prevention of encephalitis:

• Not all causes of encephalitis are preventable, particularly autoimmune forms
• Some individuals may have contraindications to certain vaccines
• Emerging infectious diseases pose ongoing challenges
• Climate change may alter the geographic distribution of vector-borne diseases
• Vaccine hesitancy in some populations can lead to decreased community protection

Encephalitis vs. Meningitis: Understanding the Differences

Encephalitis and meningitis are both serious neurological conditions that can cause inflammation in the central nervous system. While they share some similarities, understanding their differences is crucial for accurate diagnosis and treatment.

How do encephalitis and meningitis differ?

The main differences between encephalitis and meningitis include:

1. Affected area:
   • Encephalitis: Inflammation of the brain tissue itself
   • Meningitis: Inflammation of the protective membranes (meninges) covering the brain and spinal cord
2. Symptoms:
   • Encephalitis: Often includes altered mental state, personality changes, and seizures
   • Meningitis: Typically characterized by severe headache, stiff neck, and sensitivity to light
3. Causes:
   • Encephalitis: Primarily caused by viruses, sometimes by autoimmune reactions
   • Meningitis: Can be caused by viruses, bacteria, or fungi
4. Diagnosis:
   • Encephalitis: Often requires MRI or CT scans to visualize brain inflammation
   • Meningitis: Typically diagnosed through lumbar puncture and analysis of cerebrospinal fluid
5. Treatment approach:
   • Encephalitis: Focus on antiviral medications and managing brain inflammation
   • Meningitis: Treatment depends on the cause, with bacterial meningitis requiring immediate antibiotic therapy

Can encephalitis and meningitis occur together?

Yes, in some cases, inflammation can affect both the brain tissue and the meninges, a condition known as meningoencephalitis. This combined condition can be particularly severe and requires prompt, aggressive treatment.

Understanding the distinctions between encephalitis and meningitis is crucial for healthcare providers to ensure accurate diagnosis and appropriate treatment. Both conditions require immediate medical attention due to their potential for serious complications.

Encephalitis – NHS

Encephalitis is an uncommon but serious condition in which the brain becomes inflamed (swollen).

It can be life threatening and requires urgent treatment in hospital.

Anyone can be affected, but the very young and very old are most at risk.

Symptoms of encephalitis

Encephalitis usually starts off with flu-like symptoms, such as a high temperature and headache.

More serious symptoms come on over hours, days or weeks, including:

• confusion or disorientation
• seizures or fits
• changes in personality and behaviour
• difficulty speaking
• weakness or loss of movement in some parts of the body
• loss of consciousness

Dial 999 for an ambulance immediately if you or someone else has these serious symptoms.

Causes of encephalitis

It’s not always clear what causes encephalitis, but it can be caused by:

• viral infections – very rarely, encephalitis may be caused by the common viruses that causes cold sores (herpes simplex) or chickenpox (herpes varicella) spreading to the brain
• a problem with the immune system, the body’s defence against infection – sometimes something goes wrong with the immune system and it mistakenly attacks the brain, causing it to become inflamed
• bacterial or fungal infections – these are much rarer causes of encephalitis than viral infections

Some types of encephalitis are spread by mosquitoes (such as Japanese encephalitis), ticks (such as tick-borne encephalitis) and mammals (such as rabies).

You cannot catch encephalitis from someone else.

Treatments for encephalitis

Encephalitis needs to be treated in a hospital. The earlier treatment is started, the more successful it’s likely to be.

Treatment depends on the underlying cause, but may include:

• antiviral medicines
• steroid injections
• treatments to help control the immune system
• antibiotics or antifungal medicines
• painkillers to reduce discomfort or a high temperature
• medicine to control seizures or fits
• support with breathing, such as oxygen through a face mask or a breathing machine (ventilator)

How long someone with encephalitis needs to stay in hospital can range from a few days to several weeks or even months.

Recovering from encephalitis

Some people eventually make a full recovery from encephalitis, although this can be a long and frustrating process.

Many people never make a full recovery and are left with long-term problems caused by damage to their brain.

Common complications include:

• memory loss (amnesia)
• frequent seizures or fits
• personality and behavioural changes
• problems with attention, concentration, planning and problem solving
• persistent tiredness

These problems can have a significant impact on the life of the affected person, as well as their family and friends.

But help and support is available.

Preventing encephalitis

It’s not always possible to prevent encephalitis, but some of the infections that cause it can be prevented with vaccinations.

These include the:

• measles, mumps and rubella (MMR) vaccine – a routine vaccination offered to all children in England
• Japanese encephalitis vaccine – recommended for travellers to at-risk areas, such as parts of Asia
• tick-borne encephalitis vaccine – recommended for travellers to certain parts of Europe (but not the UK) and Asia
• rabies vaccination – recommended for travellers to at-risk where access to medical care is likely to be limited. Find out about rabies risks in terrestrial animals by country on GOV.UK.

Speak to a GP surgery if you’re not sure whether your vaccinations are up to date, or you’re planning to travel abroad and do not know if you need any vaccinations.

Page last reviewed: 15 May 2023
Next review due: 15 May 2026

Viral encephalitis – Better Health Channel

Summary

Read the full fact sheet

• Viral encephalitis is an inflammation of the brain caused by a virus.
• The most serious potential complication is permanent brain damage. 
• Children aged under one year and adults aged over 55 years are at increased risk of life-threatening complications.
• Treatment options include medication to relieve the symptoms and antiviral medications if appropriate.

What is viral encephalitis?

Viral encephalitis is an inflammation of the brain caused by a virus. Some viral diseases, such as measles and rubella, can also progress to involve inflammation of the brain. Other micro-organisms, such as bacteria, fungi and parasites, are capable of triggering encephalitis, but viruses – particularly the group known as enteroviruses – are the leading cause.

Once inside the blood, the viruses migrate to the brain where they start to multiply. The body notices the invasion and mounts an immune system response. This causes the brain to swell. The combination of infection and immune response creates the typical symptoms of viral encephalitis.

The most serious potential complication from viral encephalitis is permanent brain damage. Children aged under one year and adults aged over 55 years are more vulnerable to life-threatening complications.

Symptoms of viral encephalitis

The symptoms of viral encephalitis include:

• high temperature
• headache
• sensitivity to light (photophobia)
• general malaise
• stiff neck
• stiff back
• vomiting
• changes to personality
• confusion
• memory loss (amnesia)
• seizures
• paralysis
• coma.

Viruses that can cause encephalitis

Some of the viruses that are capable of causing encephalitis include:

• enteroviruses – such as coxsackievirus, poliovirus and echovirus
• herpes simplex virus
• varicella zoster virus
• Epstein-Barr virus
• cytomegalovirus
• adenovirus
• rubella
• measles
• Murray Valley encephalitis (MVE) virus and Kunjin virus
• Japanese encephalitis virus.

Modes of transmission of viruses

Viruses spread by different means, and some are more infectious than others. Some of the modes of viral transmission include:

• coughs or sneezes from an infected person that release airborne viruses, which are then inhaled by others
• infected insects (such as mosquitoes or ticks) and animals, which can transfer some viruses directly into the bloodstream via their bite
• eating contaminated food or drink
• the transfer of some viruses can occur through touching an infected person
• there is evidence to suggest that some cases of viral encephalitis are caused by a dormant viral infection (such as herpes simplex virus) becoming active again.

Infection and the immune system response

Once viruses have gained access to the bloodstream, they can multiply and spread to other parts of the body, including to the spinal cord and brain (the central nervous system). Access to the brain is by blood or nerves. After breaching the blood–brain barrier, the viruses slip inside brain cells. This disrupts, damages and ultimately ruptures the infected brain cells.

Certain viruses have a preference for different areas of the brain. For example, the herpes simplex virus likes to target the temporal lobes located near each ear.

The cells of the immune system rush to the brain and start attacking the viruses. This causes the characteristic brain swelling (cerebral oedema). Both the infection and the attempts of the body to fight the infection are responsible for the symptoms of viral encephalitis.

Complications of viral encephalitis

Babies, older people and people with reduced immunity are at increased risk of developing complications of viral encephalitis. Some of these complications include:

• low blood pressure (hypotension)
• low oxygen levels in the blood (hypoxaemia)
• bleeding inside the brain (intracerebral haemorrhage)
• permanent brain damage
• death.

Diagnosis of viral encephalitis

Viral encephalitis is diagnosed using a number of tests including:

• physical examination
• blood tests
• laboratory examination of cerebrospinal fluid (clear liquid that bathes the brain and spinal cord) removed via a lumbar puncture (a procedure in which a small needle is inserted into the lower part of the spine)
• computed tomography (CT) scan
• electroencephalography (EEG) to measure brain waves
• magnetic resonance imaging (MRI).

Treatment for viral encephalitis

Unlike bacteria, viruses are difficult to treat. Antiviral medications only work on a limited number of viruses. Treatment aims to reduce the severity of the symptoms and may include:

• hospitalisation
• antiviral medication, given intravenously, if the virus is known to be susceptible to treatment with antiviral medication (such as the herpes simplex virus)
• intravenous administration of medications to help reduce brain swelling
• pain-relieving medication
• medication to prevent vomiting
• medication to prevent seizures (anticonvulsant)
• medication to reduce fever, such as paracetamol
• fluids to prevent dehydration, but not too much as this can worsen cerebral oedema (swelling of the brain).

Long-term outlook for viral encephalitis

The severity of viral encephalitis depends on the particular virus and how quickly treatment was given. Generally, the acute phase of the illness lasts around one or 2 weeks, and the symptoms either disappear quickly or subside slowly over a period of time.

In many cases, the person makes a full recovery. In other cases, the person can be left with varying degrees of brain damage, which may require long-term supportive care and therapy.

Where to get help

• Always call an ambulance in an emergency (triple zero) Tel. 000
• Emergency department of your nearest hospital
• Your GP (doctor)
• NURSE-ON-CALL Tel. 1300 60 60 24 (24 hours, 7 days) – for confidential health advice from a registered nurse

• EncephalitisExternal Link, 2017, Medscape, USA.

This page has been produced in consultation with and approved
by:

Department of Health – Public Health – Communicable Disease Prevention and Control

Inflammation of the meninges – diagnosis and treatment at 100med

What kind of disease is this

Meningitis is often referred to as inflammation of the meninges. In the event of its occurrence, the protective layers of the spinal cord and brain become inflamed. This occurs under the influence of simple microorganisms, bacteria, fungal or viral infections. In some cases, the cause of inflammation can be medication or an injury.

Symptoms

Symptoms of inflammation of the meninges:

• increase in body temperature;

• the occurrence of hearing problems;

• significant headaches;

• nausea;

• loss of consciousness;

• vomit;

• the appearance of a rash on the skin;

• neck stiffness;

• drowsiness;

• convulsions;

• mental problems, including apathy, hallucinations, anxiety, agitation and other types.

Causes

Causes of inflammation of the meninges:

• influence of the simplest microorganisms;

• the presence of fungal infections;

• bacterial types of infections;

• viral diseases;

• a combination of several types of pathogens.

Diagnostics

Diagnosis of inflammation of the meninges is carried out as follows:

• general, PCR and biochemical blood tests;

• neurological examination;

• electroencephalography;

• puncture of the cerebrospinal type;

• CT study.

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Our expert’s opinion

Meningitis occurs in acute, fulminant and chronic forms, so only with the right approach can a correct and timely diagnosis be made. Such a complex disease requires complex treatment and high professionalism of medical personnel.

Treatment

Therapy of inflammation of the meninges is carried out in the complex:

• the use of antiviral agents;

• the appointment of antipyretics;

• the use of painkillers;

• antifungal treatment;

• antibacterial therapy.

Also during the treatment of meningitis, it is important to maintain the body’s water balance and adhere to the diet recommended by the specialist.

Prevention

Prevention and treatment of inflammation of the meninges includes vaccination recommended for children, patients with immunodeficiency and persons in contact with carriers of the disease. Also, to prevent illness, it is important to maintain a healthy lifestyle, regularly visit the fresh air, exercise, temper and avoid sources of infection. A balanced diet and the use of vitamin and mineral complexes can be a significant step in the prevention of inflammation of the meninges.

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Treatment of inflammation of the brain or spinal cord (meningitis, encephalitis, myelitis)

Treatment of inflammation of the brain or spinal cord (meningitis, encephalitis, myelitis)

Myelitis is a general term for diseases and any inflammatory processes affecting the human spinal cord. Encephalitis is a group of diseases characterized by inflammation of the brain. In turn, meningitis is an infectious disease that affects the membranes of both the spinal cord and the brain.

Causes of inflammation

Encephalitis is caused by neurotropic viruses. The disease can also occur due to complications of rubella, smallpox and measles, and infection can also occur through ticks or mosquitoes. Meningitis is caused mainly by three types of bacteria – pneumococci, meningococci and Haemophilus influenzae. Thus, the cause of inflammation of the spinal cord or brain one way or another are infections of a viral, fungal or bacterial nature, or parasites.

Symptoms

The clinical picture is determined by the general extent and severity of the lesion. In most cases, patients experience the following symptoms:

• headache
• rise in body temperature
• nausea
• sensitivity to light
• general weakness
• in extreme manifestations, paralysis, epileptic seizures, impaired consciousness, etc. are possible.

Diagnosis

To diagnose and start treatment of inflammation of the spinal cord or brain, it is necessary to be examined by a neurologist. In addition to the examination, additional studies are carried out, including:

• computed tomography of the spinal cord and/or brain
• magnetic resonance imaging
• lumbar puncture for cerebrospinal fluid analysis, etc.

Treatment of inflammation of the brain or spinal cord

In such diseases, the doctors of the Viva Clinic prescribe mainly drug therapy. As an additional treatment for inflammation of the brain and spinal cord, physiotherapy exercises, physiotherapy, and massage sessions are indicated.

Drug therapy involves taking antibiotics, vitamins, antiseptics, and other drugs. In addition, to ensure the effectiveness of the treatment of inflammation of the spinal cord and brain, an important role is played by:

• proper nutrition
• bed rest
• competent rehabilitation after recovery

Neurologists

Departments where the procedure is performed

• Clinic at Vinogradarepr.