Encephalitis
Encephalitis Overview
Encephalitis is an inflammation (cell damage) of brain tissue caused by viral infection and, more rarely, by bacterial infection. The inflammation causes the brain to swell, which leads to changes in the patient’s neurologic condition such as mental confusion and seizures.
Several thousand cases are reported each year. Many more may actually occur, since the symptoms may be mild or even non-existent in many patients. In severe cases Inflammation of the brain tissue can result in respiratory arrest, coma or death.
There are two main types:
- Primary encephalitis (or acute viral encephalitis) is caused by a direct viral infection of the spinal cord and brain.
- Secondary encephalitis (post-infective encephalitis) can result from complication of a viral infection.
Most cases of the disease in the U.S. are caused by herpes simplex virus, a bite from a rabid animal, or viruses transmitted through the bite of an infected tick, mosquito or other blood-sucking insect. Lyme disease, a bacterial infection spread by a tick bite, can cause the disease as well.
Wellstar neurologists are expert in identifying signs of encephalitis, confirming or ruling out a diagnosis and treating the condition. Our physicians work collaboratively to ensure that every patient has access to the best available medical knowledge.
Symptoms
Many people with encephalitis have very mild, flu-like symptoms. Symptoms can include:
- Headache, sometimes severe
- Fever
- Aches in muscles or joints
- Fatigue or weakness
- Confusion or agitation
- Altered consciousness
- Personality changes
- Seizures
- Skin rashes
- Sensitivity to light
- Loss of sensation or paralysis in some areas of the body
- Hallucination
- Double vision
- Perception of foul odors
- Problems with speech or hearing
Adults and older children should seek immediate care if severe headache, fever or altered consciousness persists.
Also seek medical care if any of the following symptoms is present in babies or young children:
- Bulging in the soft spots of an infant’s skull
- Nausea and vomiting
- Body stiffness
- Constant, inconsolable crying or crying that worsens when the child is picked up
- Poor feeding
Risk Factors
Anyone can get encephalitis; people at different ages are more susceptible to certain types of the disease. A risk factor for arbovirus encephalitis (the type caused by exposure to virus-causing mosquitoes) is living in rural or farming areas. The risk is higher during mosquito season.
The primary risk factor for encephalitis caused by herpes virus is exposure to bodily fluids, including saliva, or exposure to infected droplets disseminated into the air by coughing or sneezing. An infant can contract the disease from an infected mother during delivery.
Other risk factors:
- Weakened immune system
- Outdoor activities that result in exposure to ticks or mosquitoes
- Season of the year (mosquito season is late summer through early fall.)
Encephalitis Prevention
The best way to prevent encephalitis is to avoid the types of exposures that can cause the disease. If you are going to be exposed to ticks and mosquitoes:
- Wear long sleeves when mosquitoes are most active and when in wooded areas where ticks reside.
- Use mosquito repellent on skin and clothes, but be careful with young children who may put their hands in their mouths.
- Use EPA-recommended insecticide.
- Avoid mosquitoes by eliminating water sources in garden containers, old tires, etc.
Avoid viruses by taking other steps such as:
- Wash hands often with soap and water, especially before and after meals and after going to the bathroom.
- Don’t share silverware and beverages.
- Keep vaccinations up to date.
Do not hesitate to contact your doctor if you are concerned that you may have encephalitis.
Encephalitis Diagnosis
Your Wellstar neurologist will take a complete medical history and perform physical and neurological examinations.
Tools and Tests
Your doctor will use other diagnostic tools and tests including:
- Blood tests to look for signs of infection
- Urine, stool and sputum tests to check for signs of infection
- Imaging tests like MRI and CT to look for inflammation or other causes of symptoms
- Spinal tap (lumbar puncture) to obtain a sample of the fluid that surrounds the brain and spinal cord
- Electroencephalogram (EEG) to record electrical activity in the brain and check for patterns consistent with encephalitis
- Brain biopsy to remove tissue or cells for examination under a microscope
Encephalitis Treatment
Your doctor will discuss the best treatment based on your age, overall health and medical history, as well as the extent of the condition, your tolerance for certain medications and your preferences.
Mild cases may be treated with bed rest, fluids and anti-inflammatory medications like Tylenol, Motrin, etc. to relieve headaches and fever. Treatment may also include use of an antiviral medicine to destroy certain viruses.
If neurological problems persist, your doctor may recommend physical and occupational therapy. Wellstar’s expert therapists will develop an individualized treatment plan to help you regain the ability to move and perform activities in daily life. Patients with advanced cases of encephalitis will require hospitalization and follow-up assessments.