About encephalitis and meningitis

What is encephalitis and meningitis?

Encephalitis is an inflammation of the brain. Meningitis is an inflammation of the membranes (called meninges) that surround the brain and spinal cord.

  • Both infections can be caused by bacteria or viruses and rarely a fungus.
  • Headache and fever are the most common symptoms of encephalitis and meningitis. Stiff neck, confusion, or lethargy can also be present.
  • The diagnosis is usually made by performing a lumbar puncture (spinal tap).
  • A CT scan or MRI of the brain can also be helpful but usually is only done in addition to the spinal tap.
  • Treatment depends on identifying the underlying cause. If bacteria are causing the infection, then antibiotics are indicated.
  • Anyone experiencing symptoms of encephalitis or meningitis should see a doctor immediately.
  • Depending on the organism causing the infection, close contacts can also get sick and need to be evaluated by a health-care professional.
  • Basic methods that help to prevent the spread of infections (hand washing and covering ones mouth when coughing) can also help prevent the spread of some forms of meningitis.
  • Being up to date on vaccinations will help prevent certain forms of meningitis.

What is encephalitis?

Encephalitis is brain inflammation. There are many types of encephalitis, most of which are caused by infections. Most often these infections are caused by viruses. In addition to infections, encephalitis can also be caused by certain diseases that result in an inflammation of the brain.

What is meningitis?

Meningitis is inflammation of the meninges (membranes that surround the brain and spinal cord).

What is encephalomyelitis?

Encephalomyelitis is inflammation of both the brain and spinal cord. Encephalomyelitis can be caused by a variety of conditions that lead to irritation of the brain and spinal cord. Among the common causes of encephalomyelitis are viruses that infect the nervous tissues (for example, herpes zoster virus). People with encephalomyelitis can exhibit combinations of the various symptoms of either encephalitis or meningitis.

What are the symptoms for encephalitis and meningitis?

What are encephalitis symptoms and signs?

The signs and symptoms of encephalitis can range from very mild flu-like symptoms to potentially life-threatening events. Signs and symptoms of encephalitis include sudden fever, headache, vomiting, visual sensitivity to light, stiff neck and back, confusion, drowsiness, unsteady gait, and irritability. Loss of consciousness, poor responsiveness, seizures, muscle weakness, sudden severe dementia, and Memory loss can also be found in patients with encephalitis.

Anyone experiencing symptoms of encephalitis should see a doctor immediately.

What are meningitis symptoms and signs?

The classic signs and symptoms of meningitis are headache, fever, and stiff neck (in adults and older children). Symptoms of meningitis may appear suddenly and can also include Nausea and vomiting. Changes in behavior, such as confusion, sleepiness, and difficulty waking up, are other important symptoms. In infants, symptoms of meningitis are often much less specific and may include Irritability or tiredness, poor feeding, and fever.

Some types of meningitis can be deadly if not treated promptly. Anyone experiencing symptoms of meningitis should see a doctor immediately.

What are the causes for encephalitis and meningitis?

What causes encephalitis?

Encephalitis is a rare condition that is caused most often by viruses. The leading cause of severe encephalitis is the herpes simplex virus. Other causes include enterovirus infections or mosquito-borne viruses. The very young and the elderly are more likely to have a severe case.

Exposure to viruses can occur through breathing in respiratory droplets from infected people, certain insect bites, and direct skin contact.

What causes meningitis?

Meningitis may be caused by many different viruses and bacteria. It can also be caused by diseases that can trigger inflammation of tissues of the body without infection (such as systemic lupus erythematosus and Behcet's disease).

What are the treatments for encephalitis and meningitis?

Encephalitis treatment

Treatment for mild encephalitis usually consists of:

  • Bed rest
  • Plenty of fluids
  • Anti-inflammatory drugs — such as acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve) — to relieve headaches and fevers

Antiviral drugs

Encephalitis caused by certain viruses usually requires antiviral treatment.

Antiviral medications commonly used to treat encephalitis include:

  • Acyclovir (Zovirax)
  • Ganciclovir (Valcyte, Zirgan, others)
  • Foscarnet (Foscavir)

Some viruses, such as insect-borne viruses, don't respond to these treatments. But because the specific virus may not be identified immediately or at all, doctors often recommend immediate treatment with acyclovir. Acyclovir can be effective against , which can result in significant complications when not treated promptly.

Antiviral medications are generally well tolerated. Rarely, side effects can include kidney damage.

Autoimmune encephalitis

If the tests show an autoimmune cause of encephalitis, then immunosuppressant drugs such as steroids may be started.

Supportive care

People who are hospitalized with severe encephalitis might need:

  • Breathing assistance, as well as careful monitoring of breathing and heart function
  • Intravenous fluids to ensure proper hydration and levels of essential minerals
  • Anti-inflammatory drugs, such as corticosteroids, to reduce swelling and pressure within the skull
  • Anticonvulsant medications, such as phenytoin (Dilantin), to stop or prevent seizures

Follow-up therapy

If you experience complications of encephalitis, you might need additional therapy, such as:

  • Physical therapy to improve strength, flexibility, balance, motor coordination and mobility
  • Occupational therapy to develop everyday skills and to use adaptive products that help with everyday activities
  • Speech therapy to relearn muscle control and coordination to produce speech
  • Psychotherapy to learn coping strategies and new behavioral skills to improve mood disorders or address personality changes

Meningitis Treatment 

The treatment depends on the type of meningitis you or your child has.

Bacterial meningitis

Acute bacterial meningitis must be treated immediately with intravenous antibiotics and sometimes corticosteroids. This helps to ensure recovery and reduce the risk of complications, such as brain swelling and seizures.

The antibiotic or combination of antibiotics depends on the type of bacteria causing the infection. Your doctor may recommend a broad-spectrum antibiotic until he or she can determine the exact cause of the meningitis.

Your doctor may drain any infected sinuses or mastoids — the bones behind the outer ear that connect to the middle ear.

Viral meningitis

Antibiotics can't cure viral meningitis, and most cases improve on their own in several weeks. Treatment of mild cases of viral meningitis usually includes:

  • Bed rest
  • Plenty of fluids
  • Over-the-counter pain medications to help reduce fever and relieve body aches

Your doctor may prescribe corticosteroids to reduce swelling in the brain, and an anticonvulsant medication to control seizures. If a herpes virus caused your meningitis, an antiviral medication is available.

Other types of meningitis

If the cause of your meningitis is unknown, your doctor may start antiviral and antibiotic treatment while the cause is determined.

Treatment for chronic meningitis is based on the underlying cause. Antifungal medications treat fungal meningitis, and a combination of specific antibiotics can treat tuberculous meningitis. However, these medications can have serious side effects, so treatment may be deferred until a laboratory can confirm that the cause is fungal.

Noninfectious meningitis due to allergic reaction or autoimmune disease may be treated with corticosteroids. In some cases, no treatment may be required because the condition can resolve on its own. Cancer-related meningitis requires therapy for the specific cancer.

What are the risk factors for encephalitis and meningitis?

Anyone can get meningitis or encephalitis. Every year, people of all age groups are diagnosed with these conditions.

People who have autoimmune conditions or otherwise weakened immune systems may be at higher risk. Taking immune-suppressing medications can also increase your risk.

Is there a cure/medications for encephalitis and meningitis?

The prognosis for encephalitis or meningitis varies. Some cases are mild, short, and relatively benign and patients have full recovery. Other cases are severe, and permanent impairment or death is possible. This is usually determined by the type of infection present and how quickly treatment can be started. Meningitis can lead to permanent damage to the nervous system and can cause hydrocephalus. The acute phase of encephalitis may last for one to two weeks, with gradual or sudden resolution of fever and neurological symptoms. Neurological symptoms may require many months before full recovery occurs. Some patients will not fully recover.

With early diagnosis and prompt treatment, many patients recover from meningitis. Viral meningitis can be self-limited to 10 days or less. However, in some cases, the disease progresses so rapidly that death occurs during the first 48 hours, despite early treatment.

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