Encephalitis is inflammatory disease of the membranes that surround the brain and is caused by bacterial or viral infections. This rare condition mostly affects the very young or elderly people. Seasonal viral infections are the leading cause of encephalitis. These viruses occur in clusters in different locations.
The herpes simplex virus is the main cause of severe encephalitis in people of all ages. Other viruses that cause this disease include measles, polio, mumps, rabies, chickenpox and rubella. The Adenovirus, coxsackievirus, West Nile virus, cytomegalovirus, echovirus and Eastern Equine encephalitis virus also cause encephalitis.
Allergic reactions to some vaccines, autoimmune diseases, lyme disease, TB and syphilis bacteria, parasites like cysticercosis, roundworms or toxoplasmosis that affect AIDS patients and certain cancers also cause encephalitis.
Exposure to these viruses could be through contaminated food and drink, tick, mosquito or other insect bites, close proximity to an infected person that causes you to breathe in respiratory droplets and skin contact.
Types of encephalitis
There are four categories of encephalitis:
- Infectious encephalitis that causes an inflammation of the brain due to viral infections
- Post-infectious inflammation due to reaction to a vaccine or a previous infection, which can occur after several weeks
- Autoimmune encephalitis that occurs when the immune system reacts to antibodies or tumors that are non-infectious
- Chronic encephalitis that could be due to HIV, when inflammation occurs gradually over several months
Symptoms of Encephalitis
The following are the symptoms of encephalitis. You need to monitor these closely and get treatment at once. The initial stages are very dangerous and if left untreated will damage the brain.
- Flu: The first symptom of encephalitis is a high temperature 100.4ºF or more. Along with fever, a patient suffers from headaches, nausea and vomiting and joint pain.
- Changes in mental state: These serious symptoms of encephalitis come soon after the fever. The patient will become drowsy, disoriented, and confused, become clumsy and have an unsteady gait.
- Seizures: Some patients experience violent seizures or fits
- Personality changes: Since the brain gets infected and inflamed, many people suffer from personality and behavioral changes.
- Photophobia: This is sensitivity to light where a person cannot tolerate any bright lights.
- Speech: Some people will be unable to speak normally.
- Physical movements: You cannot control physical movements
- Stiff neck and back are symptoms that occur occasionally.
- Hallucinations: This is when the patient heard or seed things that are not present.
- Loss of Sensation: Certain parts of the body will lose sensation or the ability to feel pain, cold, etc.
- Loss of Vision: Some may experience partial or total vision loss.
- Involuntary movements: Eye movements can become uncontrollable and move from side to side. Similarly, arms, legs and face movements also become involuntary and uncontrolled.
Symptoms of autoimmune encephalitis could include anxiety – that is a feeling of worry, fear or unease; delusions when you believe things that are not true; unusual behavior; and paranoia when you feel that people are plotting against you or trying to get rid of you etc.
Symptoms in newborns and infants are not easily detected but it could include poor intake of food, crying frequently (especially when carried) and irritability, vomiting, soft spot on the top of the head that begins to bulge and stiffness of the body.
Emergency symptoms of encephalitis are:
- Poor responsiveness
- Severe headaches
- Changes in mental functions – extreme self-centeredness, withdrawal from society, irritability, impaired judgment, amnesia, memory loss and disinterest in every day activities.
What to do?
When a person experiences flu-like symptoms that worsen and alter the mental state accompanied with any or all the above symptoms are extremely dangerous. You must call emergency services and get the patient admitted at once.
Treatment of encephalitis
A patient who displays symptoms of encephalitis usually undergoes CSF analysis and MRI tests. Other tests could be ordered to determine the virus that is causing the disease. These include EEG, lumbar puncture, tests to detect the virus in DNA, serology tests to detect presence of antibodies and such.
Treatment is given for the fever, electrolyte disorders, seizures and dehydration. Good rest, nutrition and fluids will be recommended. Required medication will be given for 2 weeks or more. Sometimes, IV medications can be given. Antiviral, antibiotics, anti-seizure medications, sedatives, anti-inflammatory drugs and steroids are the usual medicines the doctors will prescribe.
Some patients will be given immuno-suppressant drugs that can prevent the attack on healthy tissues by the immune system.
Patients whose mind has been affected will be given emotional and reorientation support. Sometimes speech and physical therapy will be needed once the illness has been tackled.
Permanent brain damage in severe cases of encephalitis can affect memory, hearing, muscle control, vision, speech and sensation.
All forms of treatment aim at halting and reversing the infection using appropriate medication; controlling any complications that can arise from encephalitis such as dehydration from the flu and seizures; and finally prevention of long-term serious complications like damage to the brain.
Patients are often kept in an ICU and given oxygen to ease their breathing. They will also be fed nutrition and other fluids intravenously.
Encephalitis : Prevention and Precaution
The outcome of encephalitis depends on the age and severity of the disease. Those who have mild infection can recover completely. Others who have severe infections with permanent brain damage could even die. The acute phase of encephalitis is 1-2 weeks. Treatment must be started at once.
Those who are affected by encephalitis must be kept isolated. Controlling mosquitoes can reduce the changes of infections that cause encephalitis. Hence, use mosquito repellents, do not keep stagnant water in your surroundings, and wear protective clothing when going out at dusk.
Vaccines that prevent viral encephalitis are available. Other vaccines that prevent viral infections like measles and herpes zoster can prevent onset of encephalitis.
Encephalitis is rare and mortality occurs more in newborns who can also suffer from permanent neurological damage. If a particular virus becomes a severe epidemic, chances of contracting encephalitis are greater.