Encephalitis

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KEY POINTS

• Encephalitis is swelling and irritation (inflammation) of the brain most often from an infection.
• Encephalitis is treated in the hospital. You may get IV fluids and medicines to treat infections and prevent seizures.
• The best way to prevent encephalitis is to prevent infections. Ask your healthcare provider how to take care of yourself at home.

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What is encephalitis?

Encephalitis is swelling and irritation (inflammation) of the brain. Encephalitis can damage the brain and cause problems with walking, talking, and remembering. It is rare but can be life threatening. Anyone can get encephalitis, but it happens more in babies, elderly people, and people who have a weakened immune system or who have a long-term disease such as diabetes or HIV. The immune system is your body’s defense against infection.

What is the cause?

Encephalitis is usually caused by a virus. Bacteria, fungus, and parasites can also cause encephalitis. These germs are everywhere and can spread easily among people:

• Through the air such as when someone coughs or sneezes
• Through contaminated food
• By insects such as mosquitoes and ticks
• By direct skin contact, such as touching something an infected person has touched and then touching your nose, mouth, or eyes

The infection can then get to your brain by moving from another part of your body through the blood. The source may be an infection in your sinuses, ears, mouth, lungs, heart, or other places. Germs in the brain cause the tissue to swell and bleed causing infection and brain damage.

Severe allergic reactions, cancer, or an autoimmune disease can also cause encephalitis. An autoimmune disease is a disease that causes your body to mistakenly attack your own tissue.

What are the symptoms?

Your symptoms may depend on what part of your brain is affected. At first, you may feel like you have the flu. You may have a headache, fever, and muscle aches. Over several hours or days, the symptoms may get worse. More severe symptoms may include:

• Unusual drowsiness
• Confusion or memory problems
• Trouble walking
• Changes in behavior or irritability
• Sensitivity to light
• Pain or stiffness in the neck
• Skin rash
• Unusual lack of appetite
• Vomiting
• Seizures
• Coma

If you have these symptoms, call 911 for emergency help right away.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. Tests may include:

• Blood tests
• CT scan, which uses X-rays and a computer to show detailed pictures of the brain
• MRI, which uses a strong magnetic field and radio waves to show detailed pictures of the brain
• EEG (electroencephalogram), which uses small wires pasted or taped to your head to measure and record the electrical activity of your brain
• Lumbar puncture, also called a spinal tap, which uses a needle to get a sample of fluid from the area around your spinal cord

How is it treated?

Encephalitis is treated in the hospital. You may be in the intensive care unit. If you need help breathing, you may need a breathing machine. These life-support treatments are used until you start to get better. You may get IV fluids and medicines to:

• Treat a viral, bacterial or fungal infection
• Prevent or treat seizures
• Prevent or treat brain swelling
• Prevent or treat nausea and vomiting

You may start a rehabilitation (rehab) program to help you recover from problems caused by the illness. This may include physical therapy, occupational therapy, or speech therapy.

• Physical therapy can help your muscles get strong again. You will learn ways to move safely if you have weak or paralyzed muscles.
• Occupational therapy may help if you have problems doing things like eating and getting dressed.
• Speech therapy may help if you have problems with swallowing, speaking, or understanding words.

How can I take care of myself?

Follow the treatment plan your provider recommends.

Ask your provider:

• How and when you will get your test results
• How to take care of yourself at home
• How long it will take to recover from this illness
• If there are activities you should avoid and when you can return to normal activities
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

How can I help prevent encephalitis?

The best way to prevent encephalitis is to prevent infections. You can do these things to help prevent infections:

• Get all recommended vaccines.
• Avoid contact with others who are sick.
• Wash your hands often and especially after using the restroom, coughing, sneezing, or blowing your nose. Also wash your hands before eating or touching your eyes.
• Don’t share food or eating and drinking utensils with others.
• Keep surfaces clean--especially bedside tables, surfaces in the bathroom, and toys for children. Some viruses and bacteria can live several hours or more on surfaces like cafeteria tables, doorknobs, and desks. Wipe them down with a household disinfectant according to directions on the label.
• Take precautions to avoid insect bites:
  • Stay indoors at dawn, dusk, and in the early evening, when mosquitoes are most likely to be around.
  • Wear long pants and long-sleeved shirts, especially from dusk to dawn. This is the time when you are most likely to get bitten.
  • Use an insect repellent whenever you are outdoors.
  • After you have been outdoors, undress and check your body for ticks. They usually crawl around for several hours before biting. Check your clothes, too. Wash them right away to remove any ticks. If you find a tick attached to your body, remove it.
• Use latex or polyurethane condoms during foreplay and every time you have oral, vaginal, or anal sex.