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Encephalitis

Encephalitis is irritation and swelling (inflammation) of the brain, most often due to infections.

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Causes

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:

Different viruses occur in different 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:

Other viruses that cause encephalitis include:

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:

Symptoms

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:

Other symptoms include:

Symptoms in newborns and younger infants may not be as easy to recognize:

Emergency symptoms:

Exams and Tests

The health care provider will perform a physical exam and ask about symptoms.

Tests that may be done include:

Treatment

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:

If brain function is severely affected, physical therapy and speech therapy may be needed after the infection is controlled.

Outlook (Prognosis)

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.

Possible Complications

Permanent brain damage may occur in severe cases of encephalitis. It can affect:

When to Contact a Medical Professional

Go to the emergency room or call the local emergency number (such as 911) if you have:

Prevention

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.

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.

Related Information

Meningitis
Tick bite
Chickenpox
Shingles
Measles
Mumps
Rubella
Rabies
West Nile virus infection
Vaccines (immunizations) - overview
Ventriculoperitoneal shunt - discharge

References

Bloch KC, Glaser CA, Tunkel AR. Encephalitis and myelitis. In: Cohen J, Powderly WG, Opal SM, eds. Infectious Diseases. 4th ed. Philadelphia, PA: Elsevier; 2017:chap 20.

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.

Lissauer T, Carroll W. Infection and immunity. In: Lissauer T, Carroll W, eds. Illustrated Textbook of Paediatrics. 5th ed. Philadelphia, PA: Elsevier; 2018:chap 15.

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Review Date: 8/5/2018  

Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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