Understanding Encephalitis – Causes, Symptoms, Diagnosis, and Treatment Procedure

It is essential to keep in mind that encephalitis can be lethal, and assistance will be necessary for fast recovery. The signs and symptoms of encephalitis include periodic hallucinations, loss of sensation or difficulty in moving certain parts of the body, weakness in the muscle, speech and hearing problems, etc.

Keep reading to learn more about this disease and its methods of prevention.

Encephalitis is a condition that is caused by inflammation in the brain due to an infection of virus, bacteria, or troubled immune system. This ailment rarely occurs and affects the brain's cognitive functioning, which instigates behavioral changes.

There are two types of encephalitis that primarily affect the human brain: infectious encephalitis and autoimmune encephalitis. 

• Infectious or Primary Encephalitis: Infectious or primary encephalitis is caused by viral infections and is mostly generated from herpes simplex virus Types 1 and Type 2, varicella-zoster virus, and enteroviruses. In recent times, the availability of vaccines for measles, rubella, mumps, and chickenpox has reduced the chances of encephalitis at a great rate. The presence of other infectious microorganisms like bacteria, fungi, or parasites is the reason what causes encephalitis. 

• Autoimmune or Secondary Encephalitis: Autoimmune encephalitis is a situation where a person is attacked by his or her own antibodies or due to low immunity. The antibodies present in a body can target any proteins and any receptors present in the brain. The following receptors in the brain can be attacked to cause autoimmune encephalitis is:

• NMDA receptors attacked by anti-NMDA receptor encephalitis
• VGKC brain receptors, which are a protein complex comprising of LGI-1 and CASPR2, are attacked by VGKC complex antibody encephalitis.
• GABA-A and GABA-B receptors in the brain.

In the primary stage, the signs and symptoms of encephalitis showcasing mild-flu and include the following:

• Stiffness in neck
• Fever
• Headache
• Pain in joints and muscles
• Experiencing fatigue and weakness.

Moreover, in the severe stage, a person with encephalitis can show certain symptoms like:

• Confusion, restlessness, and hallucinations
• Unable to move specific parts of a body or to experience stiffness
• Weakness in muscle
• Difficulty in hearing and speech
• Unconsciousness

Apart from this, encephalitis in babies and children can bring different symptoms of encephalitis which are as follows:

• Nausea
• Vomiting
• Stiffness in different body parts
• The tendency of poor feeding or unable to wake to eat
• Facing irritation
• Soft spots on top of the skull (fontanels)

It is essential to keep in mind that children having relatively weak immune systems are prone to encephalitis and infections that directly cause harm to the brain cells.

Though the actual causes of encephalitis are unrecognisable, any autoimmune inflammation or infections arising from viruses or bacteria can lead to encephalitis. In this context, some of the prominent causes of encephalitis are mentioned down below:

• Enteroviruses: Enteroviruses, mainly poliovirus, and coxsackievirus, are responsible for symptoms highlighting common cold and flu, inflammation in the eye, and acute pain in the abdominal area. This can lead to encephalitis.

• Herpes Simplex Virus (HSV): It is to be noted that both HSV Type 1 and Type 2 can lead to encephalitis. In addition, HSV Type 1 is responsible for symptoms of cold sores and blisters around the mouth area due to fever, whereas HSV type 2 is associated with problems related to genital herpes. Commonly, an encephalitis condition caused by the HSV Type 1 is a rare condition that significantly damages the brain. In addition to this, some of the other herpes viruses, Epstein-Barr virus, and varicella-zoster virus, are associated with diseases like chickenpox and shingles.

• Mosquito-borne Virus: Mosquito-borne viruses are deadly and can cause different types of infections, namely La Crosse, St. Louis, West Nile, Eastern Equine, and Western Equine encephalitis. Generally, individuals infected with this type of virus start showing symptoms within a few days to two to three weeks and immediately require medical assistance.

• Rabies Virus: Rabies virus is generally transmitted after being bitten by an infected animal. The infection in case of these viruses spreads rapidly, leading to encephalitis.

• Tick-borne Virus: Tick-borne viruses, mostly known as Powassan viruses, are responsible for causing encephalitis. Individuals infected with this type of virus will start showing symptoms within a week after being bitten by an infected tick.

• Infections Occurred in Childhood: In addition to the above-mentioned encephalitis-causing virus, childhood infections increase the chances of the same. For example, infections like measles, mumps, or German measles, also known as rubella, can cause secondary encephalitis.

Though anybody can get infection from a virus that can cause encephalitis, certain factors accentuate the risks of encephalitis. These factors are:

• Insect Prone Areas: Infections due to mosquito or tick bites can increase if traveled to places where the following are prevalent.
• Weak Immune System: Individuals with conditions that prove weak immune systems are prone to encephalitis.
• Age: Generally, children, infants, and older people are likely to attack by an encephalitis-causing virus.

A physician performs diagnosis of encephalitis through the conduction of a thorough physical examination. In addition, doctors go through the patient's medical history to determine the severity of the condition.

However, primarily, a concerned healthcare physician will perform a series of tests to process the diagnosis.

• Brain Imaging: Brain imaging like MRI or CT scans offers a clear image of the existing swelling in the brain or any trace of a tumor.
• Lumbar Puncture: In this procedure, the insertion of a needle in the lower back eliminates a minimal amount of cerebrospinal fluid. This fluid is responsible for building protection around the brain and spinal portion. Hence any flaws in this fluid will lead to acute inflammation in the brain. Doctors collect the cerebrospinal fluid sample to locate the condition's presence and its level of proliferation.
• Electro Encephalogram (EEG): Another prominent way of diagnosing encephalitis is EEG, which shows and records the brain's electrical activity with the help of electrodes. With the help of healthcare professionals, the attachment of these electrodes to a patient’s scalp shows the following activities.
• Biopsy of the Brain: In this method, a doctor collects small sample of brain tissue for testing. He performs this testing when the condition of a patient worsens and the treatment shows no signs of improvement.

In addition to the above diagnosis methods, samples of blood or urine are sometimes collected to detect any virus or infectious agents.

Generally, the prevalent treatment of encephalitis consists of different methods depending upon the disorder's severity. For mild symptoms, individuals can take ample rest and plenty of fluids as the first process of recovery.

In addition to this, doctors may also prescribe anti-inflammatory drugs like acetaminophen (Tylenol), naproxen sodium (Aleve), and ibuprofen (Advil) to impart relief from headaches and flues. Depending on the severity of the ailment and complications, healthcare physicians can also prescribe anti-viral medications, which are:

• Foscarnet or Foscavir
• Ganciclovir or commonly available as Valcyte or Zirgan
• Acyclovir or Zovirax

It is found that if any insect-borne viruses cause encephalitis, then the drugs mentioned above may not bring any results. In this case, doctors may provide different medicinal drugs to combat the ongoing complications. Moreover, individuals suffering from autoimmune encephalitis will be treated differently.

If the patient with encephalitis has autoimmune problems, then physicians will have to prescribe immunosuppressant medicine, mostly steroids. Moreover, doctors may ask patients to take admission in a hospital in these difficult situations to receive complete treatment and continuous follow-ups.

Individuals admitted to the hospital facility need the following support:

• Continuous monitoring of breathing and heart function.
• Availability of breathing assistance
• Assurance of adequate hydration and minerals in the body in the form of intravenous fluids
• An offering of anti-inflammatory drugs, mostly corticosteroids. This medicine deals with the reduction of any swelling in the skull.
• Moreover, as one of the pivotal treatments of encephalitis, doctors also prescribe the following anticonvulsant medications for the prevention of seizures.

Healthcare physicians, upon observing the complications and symptoms of encephalitis, may recommend additional therapies, which are as follows:

1. Occupational Therapy: This therapy ensures adaptability with different products and improves skills to do everyday work.
2. Physical Therapy: Doctors recommend physical therapy to enhance body flexibility, strength, balance, and better coordination over movements.
3. Psychotherapy: In this type of therapy, the exposure of individuals to learning coping strategies and new behavioural patterns manages personality fluctuations.
4. Speech Therapy: This therapy promotes better control and coordination over speech and deals with improvement. It is advisable to follow the entire treatment and recovery plan as recommended by the healthcare professional to receive benefits and great relief.

The prevention of encephalitis is possible to a great extent is by never missing vaccines for deadly viruses like smallpox, mumps, measles, and different rubella viruses that cause inflammation in the brain.

Moreover, for individuals travelling in areas that are high-risk and prone to virus attacks, vaccines are quintessential. In addition, by protecting yourself from mosquitoes and tick bites, one can stay clear of encephalitis and its effects.

It is recommendable to approach a healthcare professional and seek medical attention once the symptoms of encephalitis are prominent. Most importantly, if there are signs and symptoms of encephalitis among children and infants, urgent medical support is quintessential.

Encephalitis, if not treated on time, can be detrimental to health; hence prevention and protection is crucial to consider. To keep this ailment at bay, it is pivotal to practice healthy and hygienic habits and adopt all the protections against encephalitis.