Encephalitis Health Article

Signs and tests

An examination may show:

• Abnormal reflexes
• Increased intracranial pressure
• Mental confusion
• Mouth ulcers
• Muscle weakness
• Neck stiffness
• Signs in other organs, such as the liver and lungs
• Skin rash
• Speech problems

Tests may include:

• Brain MRI
• CT scan of the head
• Culture of cerebrospinal fluid (CSF), blood, or urine (however, this test is rarely useful)
• Electroencephalogram (EEG)
• Lumbar puncture and CSF examination
• Tests that detect antibodies to a virus (serology tests)
• Test that detects tiny amounts of virus DNA (polymerase chain reaction -- PCR)

Treatment

The goals of treatment are to provide supportive care (rest, nutrition, fluids) to help the body fight the infection, and to relieve symptoms. Reorientation and emotional support for confused or delirious people may be helpful.

Medications may include:

• Antiviral medications, such as acyclovir (Zovirax) and foscarnet (Foscavir) -- to treat herpes encephalitis or other severe viral infections (however, no specific antiviral drugs are available to fight encephalitis)
• Antibiotics -- if the infection is caused by certain bacteria
• Anti-seizure medications (such as phenytoin) -- to prevent seizures
• Steroids (such as dexamethasone) -- to reduce brain swelling (in rare cases)
• Sedatives -- to treat irritability or restlessness
• Acetaminophen -- for fever and headache

If brain function is severely affected, interventions like physical therapy and speech therapy may be needed after the illness is controlled.

Expectations (prognosis)

The outcome varies. Some cases are mild and short, and the person fully recovers. Other cases are severe, and permanent impairment or death is possible.

The acute phase normally lasts for 1 - 2 weeks. Fever and symptoms gradually or suddenly disappear. Some people may take several months to fully recover.

Complications

Permanent brain damage may occur in severe cases of encephalitis. It can affect:

• Hearing
• Memory
• Muscle control
• Sensation
• Speech
• Vision

Calling your health care provider

Go to the emergency room or call the local emergency number (such as 911) if you have:

• Sudden fever
• Other symptoms of encephalitis