Encephalitis
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Encephalitis

Pronounced: En-sef-uh-light-iss

En Español (Spanish Version)

Definition

Encephalitis is inflammation of the brain. The inflammation may involve the whole brain, or just parts of the brain.

Encephalitis

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Causes

Viral infection of the central nervous system can be asymptomatic, present with mild symptoms, or cause meningitis and/or encephalitis. Most cases of encephalitis are caused by a viral infection. Encephalitis may be sporadic or epidemic. In the United States, the most common cause of sporadic encephalitis is the herpes simplex virus . Epidemic encephalitis are usually mosquito - or tick-borne, which may be dependant on the geography and season.

The most common viruses that cause encephalitis include:

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition. Risk factors for encephalitis include:

  • Living, working, or playing in an area where mosquito-borne viruses are common
  • Not being immunized against diseases such as:
    • Measles
    • Mumps
    • Chickenpox
    • Polio
  • Having cancer
  • Taking immunosuppressive medications after organ transplant
  • Having AIDS

Newborns of mothers who have genital herpes simplex are at risk for herpes simplex encephalitis.

Symptoms

The symptoms may range from mild, such as fever and headache, to severe, such as seizures , loss of consciousness, and permanent neurological damage. Death may also result.

Symptoms include:

  • Fever
  • Weakness, severe fatigue
  • Headache
  • Sensitivity to light
  • Stiff neck and back
  • Vomiting
  • Changes in consciousness
  • Muscle aches
  • Rash
  • Personality changes
  • Confusion
  • Irritability
  • Seizures
  • Partial or complete paralysis
  • Progressive drowsiness
  • Yawning
  • Trouble walking
  • Trouble speaking
  • Trouble swallowing

Diagnosis

The doctor will ask about your symptoms and medical history, and perform a physical exam.

Tests may include:

  • Blood tests—to look for signs of infection
  • Spinal tap—to test spinal fluid for signs of infection
  • CT and/or MRI scans of the head—to look for abnormal areas of enhancement, hemorrhage, or edema in the brain
  • Electroencephalogram (EEG)— to look for abnormal electrical activity in the brain
  • Brain biopsy—removal of a small sample of brain tissue to test for signs of infection

Treatment

Treatment is mostly supportive. It may include:

  • Antiviral drugs (eg, intravenous acyclovir for herpes simplex encephalitis)—to potentially help shorten the duration of the illness
  • Steroid medications—to decrease brain swelling
  • Diuretics such as mannitol—to decrease elevated intracranial pressure
  • Intubation with hyperventilation—to decrease elevated intracranial pressure
  • Anticonvulsant medications—to prevent and/or treat seizures

Prevention

Make sure that you and your children are vaccinated against preventable viral illnesses.

RESOURCES:

Encephalitis Information Resource
http://www.encephalitis.info

National Institute of Neurological Disorders and Stroke
http://www.ninds.nih.gov

CANADIAN RESOURCES:

BC Health Guide
http://www.bchealthguide.org/

Health Canada
http://www.hc-sc.gc.ca/index_e.html

References:

Cecil Textbook of Medicine . 21st ed. WB Saunders Company; 2000.

Conn's Current Therapy 2001 . 53rd ed. WB Saunders Company; 2001.

Emergency Medicine: Concepts and Clinical Practice . 4th ed. Mosby-Year Book; 1998.

Herpes simplex encephalitis. EBSCO Publishing Dynamed website. Available at: http://www.ebscohost.com/dynamed . Updated December 2, 2007. Accessed Feb 23, 2008.

Principles and Practice of Infectious Diseases . 6th ed. Churchill Livingstone; 2005.

Samuels MA, Feske SK. Office Practice of Neurology . Philadelphia, PA: Churchill Livingstone; 2003.



Last reviewed February 2008 by J. Thomas Megerian, MD, PhD, FAAP

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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