Encephalitis (मस्तिष्क की सूजन)

Encephalitis—an inflammation of the brain tissue—is a potentially life-threatening condition that demands rapid recognition and treatment. Drawing on over 11 years of neurology experience, I’ll explain the causes, tell-tale signs, diagnostic steps, and effective therapies in clear, compassionate language.

What Is Encephalitis?

Encephalitis occurs when the brain becomes inflamed, most often due to viral infections such as herpes simplex, enteroviruses, or arboviruses. Autoimmune encephalitis—where the immune system attacks brain cells—has also become increasingly recognized. To explore the various causes, see the Mayo Clinic’s overview of encephalitis.

Recognizing the Signs

Encephalitis symptoms can develop rapidly over hours to days and typically include:

High fever and headache
Altered mental status: confusion, disorientation, or lethargy
Seizures or involuntary movements
Sensitivity to light (photophobia) and neck stiffness
Focal neurological deficits: weakness, speech difficulties, or coordination problems

In children, look for irritability, poor feeding, or excessive sleepiness. For a broader list of warning signs, refer to the Centers for Disease Control and Prevention’s encephalitis guide.

How We Diagnose Encephalitis

Clinical Assessment: Immediate evaluation of vital signs, mental status, and neurological exam.
Lumbar Puncture: Cerebrospinal fluid (CSF) analysis for cell counts, protein, glucose, and PCR testing for viral DNA/RNA.
Neuroimaging: MRI with contrast detects areas of inflammation, swelling, or hemorrhage.
Electroencephalogram (EEG): Assesses electrical brain activity, identifying seizure patterns or diffuse slowing.
Laboratory Tests: Blood cultures, autoimmune antibody panels, and metabolic screens.

Prompt diagnosis using these modalities—aligned with the World Health Organization’s recommendations for neurological infections—guides targeted therapy and improves outcomes.

Treatment Strategies

1. Antiviral & Immunotherapy

Acyclovir: Initiated empirically for suspected herpes encephalitis until PCR results are available.
Other antivirals: Target specific viruses based on CSF findings.
Autoimmune Encephalitis: High-dose corticosteroids, intravenous immunoglobulin (IVIG), or plasma exchange to suppress aberrant immune responses.

2. Supportive Care

Seizure Control: Antiepileptic medications such as levetiracetam.
Intracranial Pressure Management: Head elevation, osmotic agents (mannitol), and hyperventilation in critical cases.
Fever & Pain Control: Antipyretics and analgesics.
Nutrition & Hydration: Parenteral or enteral support when oral intake is compromised.

3. Rehabilitation & Long-Term Follow-Up

After the acute phase, tailored rehabilitation addresses residual deficits:

Physiotherapy for strength and coordination
Occupational Therapy for daily living skills
Speech Therapy to improve language and swallowing functions
Neuropsychological Support for memory, mood, and cognitive therapy

Prognosis & Prevention

Recovery varies by cause and severity. Early antiviral or immunotherapy improves outcomes, while delays can lead to lasting neurological deficits. Prevention strategies include:

Vaccination against preventable viral causes such as measles and Japanese encephalitis.
Mosquito control measures to reduce arboviral encephalitis risk.
Prompt management of systemic infections to prevent brain involvement.

When to Seek Immediate Help

Encephalitis is a medical emergency. If you or a loved one develop high fever with headache, confusion, seizures, or focal weakness, call emergency services immediately.

To arrange urgent evaluation or learn more:

—Dr. Rohit Anand
Consultant Neurologist, Jamshedpur