EncephalitisSymptoms, Doctors, Treatments, Advances & More
Learn About Encephalitis
Encephalitis is irritation and swelling (inflammation) of the brain, most often due to infections.
Encephalitis is a rare condition. It occurs more often in the first year of life and decreases with age. The very young and older adults are more likely to have a severe case.
Encephalitis is most often caused by a virus. Many types of viruses may cause it. Exposure can occur through:
- Breathing in droplets from the nose, mouth, or throat from an infected person
- Contaminated food or drink
- Mosquito, tick, and other insect bites
- Skin contact
Different viruses occur in different geographic locations. Many cases occur during a certain season.
Encephalitis caused by the herpes simplex virus is the leading cause of more severe cases in all ages, including newborns.
Routine vaccination has greatly reduced encephalitis due to some viruses, including:
- Measles
- Mumps
- Polio
- Rabies
- Rubella
- Varicella (chickenpox)
Other viruses that cause encephalitis include:
- Adenovirus
- Coxsackievirus
- Cytomegalovirus
- Eastern equine encephalitis virus
- Echovirus
- Japanese encephalitis, which occurs in Asia
- West Nile virus
After the virus enters the body, the brain tissue swells. This swelling may destroy nerve cells, and cause bleeding in the brain and brain damage.
Other causes of encephalitis may include:
- An allergic reaction to vaccinations
- Autoimmune disease
- Bacterial infections such as Lyme disease, syphilis, and tuberculosis
- Parasites such as roundworms, cysticercosis, and toxoplasmosis in people with HIV/AIDS and other people who have a weakened immune system
- The effects of cancer
Some people may have symptoms of a cold or stomach infection before encephalitis symptoms begin.
When this infection is not very severe, the symptoms may be similar to those of other illnesses:
- Fever that is not very high
- Mild headache
- Low energy and a poor appetite
Other symptoms include:
- Clumsiness, unsteady gait
- Confusion, disorientation
- Drowsiness
- Irritability or poor temper control
- Light sensitivity
- Stiff neck and back (sometimes)
- Vomiting
Symptoms in newborns and younger infants may not be as easy to recognize:
- Body stiffness
- Irritability and crying more often (these symptoms may get worse when the baby is picked up)
- Poor feeding
- Soft spot on the top of the head may bulge out more
- Vomiting
Emergency symptoms:
- Loss of consciousness, poor responsiveness, stupor, coma
- Muscle weakness or paralysis
- Seizures
- Severe headache
- Sudden change in mental functions, such as flat mood, impaired judgment, memory loss, or a lack of interest in daily activities
The goals of treatment are to provide supportive care (rest, nutrition, fluids) to help the body fight the infection, and to relieve symptoms.
Medicines may include:
- Antiviral medicines, if a virus caused the infection
- Antibiotics, if bacteria are the cause
- Antiseizure medicines to prevent seizures
- Steroids to reduce brain swelling
- Sedatives for irritability or restlessness
- Acetaminophen for fever and headache
If brain function is severely affected, physical therapy and speech therapy may be needed after the infection is controlled.
Johns Hopkins Outpatient Center
Dr. Probasco is a professor at the Johns Hopkins University School of Medicine Department of Neurology. He is the Vice Chair for Quality, Safety, and Service for the department. He also serves as the Director of the Johns Hopkins Division of Advanced Clinical Neurology as well as the Medical Director of the Johns Hopkins Inpatient General Neurology Service. He co-directs the Johns Hopkins Encephalitis Center and the Johns Hopkins Center for Refractory Status Epilepticus and Neuroinflammation. He cares for general neurology inpatients and outpatients, specializing in autoimmune and paraneoplastic syndromes as well as neurological immune-related adverse events following immunotherapies for cancer. After completing his undergraduate studies in biochemistry at the University of New Mexico, Dr. Probasco attended the University of Oxford as a Rhodes Scholar and earned a second undergraduate degree in psychology, philosophy and physiology. He went on to earn his medical degree at the University of California, San Francisco. He completed an internship in internal medicine at Johns Hopkins Bayview Medical Center and a residency in neurology at Johns Hopkins, where he was the faculty liaison/executive chief resident. He went on to complete an instructorship in inpatient general neurology at Johns Hopkins. Dr. Probasco’s research interests include increasing care value through improving outcomes, incorporation of patient experience of disease and treatment, the efficiency of care delivery, and diagnostic test utilization in general and specifically in relation to autoimmune and paraneoplastic neurological syndromes, including encephalitis. Finally, he is interested in the management of neurological immune-related adverse events following immunotherapies for the treatment of cancer. Dr. Probasco has been recognized at the departmental, institutional, and national levels for teaching and clinical excellence, including the American Academy of Neurology’s A.B. Baker Teacher Recognition Award and the Frank L. Coulson, Jr. Award from the Johns Hopkins Medicine Miller-Coulson Academy of Clinical Excellence. He is a past graduate of the Johns Hopkins Armstrong Institute Resident Scholars (AIRS) program in Patient Safety and Quality. As a faculty member, he was inducted into the Miller-Coulson Academy of Clinical Excellence in 2019. He serves as Editor-in-Chief of NEJM Journal Watch Neurology. Videos The impact of COVID-19 on the Department of Neurology‚Äôs clinical care and medical education programs. Dr. Probasco is rated as an Elite provider by MediFind in the treatment of Encephalitis. His top areas of expertise are Encephalitis, Anti-NMDA Receptor Encephalitis, Status Epilepticus, Creutzfeldt-Jakob Disease, and Gastrostomy.
Johns Hopkins Outpatient Center
Dr. Arun Venkatesan serves as Director of the Johns Hopkins Encephalitis Center, where he directs clinical activities and research. At the center he has developed a multidisciplinary program devoted to optimizing diagnosis and management of patients with infectious and autoimmune encephalitis and understanding mechanisms of disease in order to develop more effective treatments. He also plays an active role in the Johns Hopkins Multiple Sclerosis and Transverse Myelitis Centers. He received his undergraduate degree in biomedical engineering from the University of California, Berkeley in 1994, followed by a Ph.D. in microbiology and immunology and an M.D. from the University of California, Los Angeles. He completed his residency in neurology and fellowship in neuroinfectious and neuroinflammatory diseases at Johns Hopkins, after which he was appointed to the faculty in the department of neurology in 2007. His laboratory research focuses on defining causes and mechanisms of central nervous system injury in the setting of infection and neuroinflammation, with a goal towards developing protective and regenerative strategies. He has received funding from the National Institutes of Health, Howard Hughes Medical Institute, National Multiple Sclerosis Society, and Maryland Stem Cell Research Fund. Dr. Venkatesan is rated as an Elite provider by MediFind in the treatment of Encephalitis. His top areas of expertise are Encephalitis, Herpes Simplex Encephalitis, Anti-NMDA Receptor Encephalitis, and Multiple Sclerosis (MS).
Cleveland Clinic Main Campus
Amy Kunchok is a Neurologist in Cleveland, Ohio. Dr. Kunchok has been practicing medicine for over 23 years and is rated as an Elite provider by MediFind in the treatment of Encephalitis. Her top areas of expertise are Encephalitis, Multiple Sclerosis (MS), Anti-NMDA Receptor Encephalitis, Optic Neuritis, and Thymectomy.
The outcome varies. Some cases are mild and short, and the person fully recovers. Other cases are severe, and permanent problems or death is possible.
The acute phase normally lasts for 1 to 2 weeks. Fever and symptoms gradually or suddenly disappear. Some people may take several months to fully recover.
Permanent brain damage may occur in severe cases of encephalitis. It can affect:
- Hearing
- Memory
- Muscle control
- Sensation
- Speech
- Vision
Go to the emergency room or call 911 or the local emergency number if you have:
- Sudden fever
- Other symptoms of encephalitis
Children and adults should avoid contact with anyone who has encephalitis.
Controlling mosquitoes (a mosquito bite can transmit some viruses) may reduce the chance of some infections that can lead to encephalitis.
- Apply an insect repellant containing the chemical DEET when you go outside (but do not use DEET products on infants younger than 2 months).
- Remove any sources of standing water (such as old tires, cans, gutters, and wading pools).
- Wear long-sleeved shirts and pants when outside, especially at dusk.
Children and adults should get routine vaccinations for viruses that can cause encephalitis. People should receive specific vaccines if they are traveling to places such as parts of Asia, where Japanese encephalitis is found.
Vaccinate animals to prevent encephalitis caused by the rabies virus.
Summary: There is no approved standard treatment für progressive multifocal leukoencephalopathy (PML). The sponsor of the study is developing a new treatment. For this reason, the investigational medicinal product (IMP) called 'human allogenic HPyV-2-specific T cells' is to be tested in this study. The sponsor wants to find out whether the IMP is safe, influences the neurological status and improves the qu...
Summary: The goal of this observational study is to investigate the frequency and the possible pathogenic role of neuronal synaptic antibodies (NSAb) in patients with cognitive impairment (CI). The main questions it aims to answer are: 1. the frequency and associated features of NSAb in patients with CI and the usefulness of a clinical score in improving autoimmune dementia (AID) diagnosis; 2. the clinical...
Published Date: July 16, 2024
Published By: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Beckham JD, Tyler KL. Encephalitis. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 89.
Bronstein DE, Glaser CA. Encephalitis and meningoencephalitis. In: Cherry JD, Harrison GJ, Kaplan SL, Steinbach WJ, Hotez PJ, eds. Feigin and Cherry's Textbook of Pediatric Infectious Diseases. 8th ed. Philadelphia, PA: Elsevier; 2019:chap 36.