ENCEPHALITIS, VIRAL

 Basic information

description

Viral encephalitis is inflammation of the brain. It can be primary (the virus attacks the brain and spinal cord directly). It can be secondary (virus infects other body tissue and then spreads to the brain). Encephalitis is rare and can occur at any age. Symptoms may be more severe in the very young or the elderly.

FREQUENT SIGNS & SYMPTOMS

• In some cases, there may be no symptoms or they are mild and flu-like.
• Fever.
• Headache (may be mild to severe).
• Nausea and vomiting.
• In infants, a bulging of the soft spot of the skull.
• Lethargy or lack of energy.
• Stiff neck.
• Drowsiness.
• Eyes are sensitive to light.
• Confusion; behavioral or personality changes.
• Seizures.
• Speech, hearing, or vision problems.
• Muscle weakness or partial paralysis.
• Loss of consciousness; coma in severe cases.

causes

Encephalitis can be caused by one of many types of viruses. In the United States, the most common is the herpes simplex virus (it causes cold sores). It can also be caused by arboviruses (which are transmitted by mosquitoes or ticks), viruses that cause mumps or measles or chickenpox, or more rarely, the rabies virus, and others.

risk increases with

• Newborns and infants and adults over 60.
• Weak immune system due to illness or drugs.
• Living in areas with a large mosquito population.

PREVENTIVE MEASURES

• Get medical care for viral infections.
• Take precautions to prevent mosquito bites.
• Get vaccines for mumps, measles, rubella, chickenpox, and the flu.

expected outcomes

Mild viral encephalitis may go unnoticed. In other cases, symptoms last 3 to 5 days. Complications from encephalitis are more likely in infants and the elderly. People in other age groups usually recover completely, but it may take several months.

possible complications

• A very small number of people suffer permanent brain damage that impairs mental or muscle functions.
• Coma and death (rare).

 diagnosis & treatment

general measures

• Your health care provider will do a physical exam and ask questions about your symptoms and activities. Medical tests may include studies of blood and spinal fluid, CT, MRI, and electroencephalogram (which records brain waves). A brain biopsy (removal of a small amount of tissue for viewing under a microscope) may be done.
• Hospital care is usually needed, especially for severe symptoms. Supportive care will be provided for breathing or heart problems. Fluid and electrolyte levels will be monitored. Steps will be taken to prevent complications.
• If brain function is affected, physical therapy, speech therapy, and behavioral therapy may be recommended.

medications

• Your health care provider may prescribe:
  • Pain relievers, for headache or fever.
  • Antiviral drugs, for certain viral infections.
  • Drugs to reduce inflammation.
  • Drugs to control seizures if needed.

activity

Reduce activity until the pain and fever are gone. Gradually return to normal activity. Allow 2 or more months for complete recovery.

diet

No special diet. May require fluids given through a vein (IV) while in the hospital.

 notify our office if

• You or a family member has symptoms of encephalitis.
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.
• Symptoms recur after treatment.

Special Notes: