Encephalitis - Symptoms, Complications, and Expert Management

What Is Encephalitis?

It is an inflammatory condition of the brain due to an infection or other causes. Most of the time, it is caused by a virus. Inflammation causes the brain to swell, and its functional abilities get impaired. Depending on the degree and progress of the infection, the individual may suffer mental confusion, seizures, loss of consciousness, paralysis, or even death. Encephalitis can have severe, long-lasting complications in an individual, so timely care is essential.

What Are the Symptoms of Encephalitis?

In the initial phase of infection, the infectious agent stays inactive in the body without causing any illness. This is followed by the onset of symptoms which are general to any infection accompanied by several neurological issues.

The most common symptoms include:

1. Sudden onset of a high fever that lasts for an extended period.

2. Headaches; that are as severe as a migraine.

3. Pain and stiffness of the neck and other joints.

4. Weakness of the body.

5. Feeling nauseated.

6. Rashes on the skin.

There are several neurologic symptoms, such as:

1. Convulsions (seizures) and tremors.

2. Drowsiness and inactivity.

3. Unable to think and function properly.

4. Mental confusion.

5. Hallucinations.

6. Changes in usual behavior.

7. Speech problems.

8. Difficulty walking and making coordinated movements.

9. Memory loss.

10. Discomfort with bright lights.

11. In advanced stages, the individual may become unconscious (coma).

The symptoms that last for long, even after recovery, maybe:

1. General weakness.

2. Inability to focus and memorize things.

3. Eyesight issues.

4. Problems with speech and use of language.

5. Loss of hearing.

6. Lack of coordination and body balancing.

7. Altered behavior and personality.

8. Frequent mood swings and bad temper.

9. Learning disorders and seizures.

What Are the Causes of Encephalitis?

The most frequent cause is an infection from a virus. Often, it starts as an upper respiratory infection or a stomach infection and spreads to the brain. It can occur at any age, though young children, older adults, and those with weaker immunity are more susceptible. In addition, if the mother’s birth canal is infected, the newborn can develop encephalitis. The common causes are:

• Viral infections from - herpes virus, human immunodeficiency virus (HIV), enterovirus, influenza virus, West Nile virus, chickenpox virus (varicella), measles, mumps, rubella, rabies, and Zika virus.

• Bacteria such as Neisseria meningitidis.

• Fungi such as Candida, Mucormycosis, and Cryptococcus.

• Mosquito bites that cause Murray Valley encephalitis (MVEV), Australian encephalitis, and Equine encephalitis.

• Tick-borne encephalitis (TBE) (Lyme disease, Rocky Mountain spotted fever).

• Cats may cause toxoplasmosis (cat-scratch disease).

• Autoimmune encephalitis (AE), where the immune system of the body malfunctions and attacks one’s own brain to cause inflammation.

• Certain chemicals like arsenic, lead, and mercury may trigger inflammation in the brain.

• Occasionally, severe meningitis (inflammation of the outer layers covering the brain) results in encephalitis.

How Is Encephalitis Diagnosed?

The healthcare professional will get a complete medical history and details of previous vaccinations. Discussing the symptoms and other recent health issues will help them understand the severity and extent of the infection. Identifying whether the underlying cause of inflammation is viral, bacterial, or autoimmune encephalitis is mandatory. A physical examination can confirm the diagnosis of encephalitis, followed by neurological exams to evaluate brain function. The additional strategies are:

• Imaging Studies: Usually, the doctor orders a computed tomography (CT) scan, magnetic resonance imaging (MRI), or electroencephalography (EEG) to understand the extent of inflammation, look for brain damage and rule out other conditions like a brain tumor, stroke, or bleeding inside the brain.

• Spinal Tapping: Or lumbar puncture, where the doctor takes a sample of the spinal fluid to confirm the type of infection and level of inflammation.

• Lab Tests: Involving blood, urine, and stool samples; to identify the type of infectious agent and also to quantify the infection.

What Is the Treatment Strategy for Encephalitis?

Chances of recovery depend on how soon the treatment starts after getting affected. The patient usually requires undivided attention and medical care at a hospital set up along with drugs to treat the underlying cause and stabilize the condition. A critically ill individual may need external mechanical help for breathing or a ventilator. Such supportive care should continue till the patient attains recovery. The critical stage of the disease lasts for one or two weeks, and fever and other symptoms may improve over time. However, complete recovery may take a while. Treatment involves:

1. Steroids to bring down inflammation. This helps in reducing the swelling and fluid collection in the brain.

2. Antiviral medication such as Acyclovir.

3. Antibiotics and antifungal drugs as per requirement.

4. Medication to treat seizures.

5. Pain-relieving medications and sedatives.

6. Fluids to maintain water content in the body and nutrient supply as required.

7. The individual should take adequate nutrition, rest, and sleep properly to recover from the fatigue associated with the disease.

8. Patients who suffer long-lasting consequences from encephalitis may require rehabilitation and lifestyle training to improve their quality of life and better functioning.

9. Doctors also advise physical, occupational, or speech therapy to compensate for muscle weakness and speech issues.

10. Regular health evaluation and follow-up are mandatory for an extended period.

How to Prevent Contracting Encephalitis?

Like other infections, one may practice good hand hygiene to prevent transmitting the microbes that cause encephalitis. Wash hands before and after meals and also after using the toilet. If an infected person is in the house, avoid sharing the utensils and get other objects for daily use. In case of encephalitis outbreaks, childcare centers and out-of-home daycare facilities should take utmost care to safeguard children from catching the infection.

The best way to prevent catching encephalitis due to an infection is to get vaccinated. Vaccines are available against viral diseases such as mumps, measles, and rubella. One can also get vaccinated for rabies, tick-borne infections, and Japanese encephalitis to avoid specific conditions. And always be on guard for mosquito bites by using insect repellents and clothes that cover the skin completely. Dry out or fill up any stagnant water sources around the area to prevent mosquitoes from laying eggs and growing in numbers.

Conclusion:

Encephalitis can be a debilitating disease if delayed or avoided. It has potentially life-threatening consequences. The chances of recovery depend on the underlying cause of encephalitis and inflammation of the brain. Early diagnosis and timely medical care can bring the individual back to life.