Encephalitis: Symptoms, Causes, Diagnosis and Treatment

Written by Medicover Team and Medically Reviewed by Dr Krishna Haskar Dhanyamraju , Neurologists

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1. Causes 2. Find a Doctor 3. Diagnosis 4. Treatment 5. FAQs

Encephalitis is a serious condition characterized by inflammation of the brain tissue, most commonly caused by viral infections, although bacterial infections, autoimmune disorders, and other causes can also trigger it. The condition may develop rapidly and can affect people of all ages. Symptoms range from fever, headache, and confusion to seizures, weakness, altered consciousness, and coma in severe cases. Early diagnosis and prompt treatment are essential to reduce brain damage, prevent life-threatening complications, and improve long-term neurological outcomes.

What are the Symptoms of Encephalitis?

The majority of patients who have viral encephalitis experience flu-like symptoms, such as:

Headache
Neck stiffness
Fever
Aches and pains in the muscles and joints
Weakness
Exhaustion

The signs and symptoms can be more severe at times such as :

Confusion, agitation, or hallucinations, symptoms of schizophrenia.
Seizures
Sensation loss or inability to move some parts of the face or body
Muscle deterioration
Speech or hearing difficulties
Consciousness loss (including coma)

Signs and symptoms in newborns and young children may include:

Bulging in an infant's skull's soft areas
Vomiting and nausea
Stiffness in the body
Feeding problems or not waking up for a feeding
Irritability

What are the Causes of Encephalitis?

Encephalitis can be caused by autoimmune inflammation, viral and bacterial infections, and noninfectious inflammatory conditions. There are two types of encephalitis: acute and chronic.

Primary encephalitis is a type of encephalitis that affects the brain when a virus or other agent infects the brain directly. It's possible that the infection is localized or widespread. A primary infection could be the reactivation of a virus that was dormant during a previous illness.
Secondary encephalitis is a type of encephalitis that affects the brain A faulty immune system response to an infection elsewhere in the body causes this condition. Instead of attacking only the infected cells, the immune system accidentally attacks healthy brain cells. Secondary encephalitis, also known as post-infection encephalitis, occurs 2 to 3 weeks after the initial infection.

Viral causes:

The following viruses can cause encephalitis:

Herpes simplex virus It is a virus that causes genital herpes (HSV). HSV type 1 (which causes cold sores and blisters around the mouth) and HSV type 2 (which causes genital herpes) can both cause encephalitis. HSV type 1 encephalitis is uncommon, although it can cause serious brain damage or death.
Herpes viruses The Epstein-Barr virus, which causes infectious mononucleosis, and the varicella-zoster virus, which causes chickenpox and shingles, are two examples.
Enteroviruses The poliovirus and the coxsackievirus, for example, are viruses that induce flu-like symptoms, eye irritation, and abdominal pain.
Viruses spread by mosquitos There are certain viruses carried by mosquitos that can cause this condition. After being exposed to a mosquito-borne virus, symptoms of infection may occur from a few days to a few weeks.
Viruses spread by ticks Ticks or insects carry the virus, which causes encephalitis. Symptoms typically occur a week after being bitten by an infected insect.
Rabies Once infected with the rabies virus, which is usually transmitted through a bite from an infected animal, symptoms progress quickly to encephalitis.
Infections in children Secondary encephalitis used to be caused by common childhood infections like measles (rubeola), mumps, and German measles (rubella). Due to the availability of vaccines for these diseases, these causes are now uncommon in the United States.

When to See a Doctor for Encephalitis?

Anyone with fever accompanied by confusion, severe headache, seizures, or changes in consciousness should seek immediate evaluation by an Emergency Physician. Ongoing care may involve a Neurologist or Infectious Disease Specialist.

You should seek medical care immediately if you experience:

Persistent fever with severe headache
Confusion, memory problems, or unusual behavior
Difficulty speaking or weakness in the arms or legs

Seek emergency medical attention immediately if you:

Have a seizure or lose consciousness
Develop severe drowsiness, coma, or breathing difficulties
Experience sudden neurological symptoms such as paralysis or severe confusion

These symptoms may indicate severe brain inflammation requiring emergency hospital treatment.

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How is Encephalitis Diagnosed?

Your doctor will begin by performing a complete physical examination and reviewing your medical history. Following that, your doctor might suggest:

MRI (magnetic resonance imaging) MRI (magnetic resonance imaging) An MRI or CT scan can identify any brain enlargement or another illness, such as a tumour, that is causing your symptoms.
Lumbar puncture A little amount of cerebrospinal fluid (CSF), the protective fluid that surrounds the brain and spinal column, is removed using a needle. Infection and inflammation in the brain might be indicated by changes in this fluid. CSF samples can sometimes be examined to determine the reason. This could be due to a virus, another illness, or an autoimmune condition.
Other laboratory tests Viruses and other infectious agents can be detected in blood, urine, or excretions from the back of the neck.
EEG (electroencephalogram) EEG (electroencephalogram) The electrical activity of your brain is recorded by electrodes attached to your scalp. A diagnosis of encephalitis might be made based on certain aberrant patterns.
Brain biopsy A small sample of brain tissue may be taken for testing on rare occasions. Only if symptoms are becoming worse and treatments aren't working is a brain biopsy recommended.

What is the Treatment for Encephalitis?

Treatment for mild encephalitis usually consists of the following:

Rest in bed.
Drinking plenty of fluids.
Corticosteroids to reduce inflammation in the brain.

Medications

Antiviral medications can treat viral encephalitis by addressing the underlying cause.
Antibiotics are used to treat bacterial infections that can lead to encephalitis.
Antifungal medications can aid with fungal encephalitis.
Anticonvulsant drugs can help with seizures caused by encephalitis.
Surgery If doctors discover that encephalitis was caused by a tumour or other growth, they may undertake surgery to remove it.
Immunoglobulin therapy A doctor will provide a solution containing a large number of antibodies from donated blood during immunoglobulin therapy. This is frequently done through an IV.
The therapeutic plasma exchange This procedure removes blood from the body and filters out antibodies, which helps to protect the body from being attacked by them. The person's blood is then replaced with albumin or donated blood by a doctor. Albumin is a protein produced by the liver.

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What are the Complications of Encephalitis?

Here are the complications of encephalitis in bullet points:

Brain Damage: In severe cases, encephalitis can cause permanent brain damage, affecting memory, cognition, and motor skills.
Seizures: Many individuals with encephalitis experience seizures, which may persist even after the infection resolves.
Neurological Issues: Long-term difficulties such as muscle weakness, paralysis, and poor coordination may occur.
Cognitive Impairments: Long-term cognitive impairments can include memory loss, confusion, difficulty focusing, and mood swings.
Vision Problems: Encephalitis may lead to vision disturbances or even partial loss of vision due to damage to the brain areas responsible for sight.
Behavioural Changes: Some people may experience significant changes in behavior or personality due to the impact of encephalitis on the brain.
Speech and Swallowing Difficulties: Damage to certain parts of the brain can affect speech, language, and swallowing functions.
Hearing Loss: Some forms of encephalitis can lead to hearing impairment or loss if the brain regions controlling hearing are affected.

What are the Risk Factors for Encephalitis?

Encephalitis can strike anyone at any time. The following are some of the factors that may raise your risk:

Age In some age groups, certain kinds of encephalitis are more common or more severe. Most types of viral encephalitis put young children and older individuals at a higher risk.
Weak immune system Encephalitis is more likely in those who have HIV/AIDS, take immune-suppressing medicines, or have another illness that weakens the immune system.
Seasons In some seasons like the rainy season and winter season mosquito and tick-borne diseases are more common.

What is the Recovery Process for Encephalitis?

Recovery depends on the cause of encephalitis, the severity of brain inflammation, and how quickly treatment begins. While many individuals recover completely, others may experience long-term neurological, cognitive, or physical difficulties that require ongoing rehabilitation. Regular follow-up helps monitor recovery and manage any lasting complications.

Completing prescribed treatments, participating in rehabilitation programs, attending follow-up appointments, getting adequate rest, maintaining good nutrition, and seeking prompt medical care for recurrent neurological symptoms help support long-term recovery and improve quality of life.

Recovery Includes

Completing all prescribed medications.
Participating in physical, occupational, and speech therapy when needed.
Attending regular neurological follow-up appointments.
Managing seizures with prescribed medications if required.
Gradually returning to daily activities under medical guidance.
Monitoring for persistent cognitive or neurological symptoms.

Frequently Asked Questions

1. Can encephalitis be treated?

Treatment depends on the cause. Antiviral drugs can be used to treat viral encephalitis, while antibiotics may be recommended for bacterial infections. Supportive treatment is also necessary.

2. How long does it take to recover from encephalitis?

Recovery time varies. Mild cases might improve in weeks, but for severe encephalitis, recovery may take months, and some people may experience long-term neurological effects.

3. Is encephalitis hereditary?

Encephalitis itself is not hereditary, but certain people may have a genetic predisposition to certain autoimmune or viral conditions that increase their chances of having it.