Encephalitis

Encephalitis

Encephalitis or encephalitis is inflammation of the brain tissue which can cause symptoms of nervous disorders. Symptoms can include loss of consciousness, seizures, or disturbances in movement.

Inflammation of the brain can occur due to viral, bacterial, or fungal infections. This disease is more common in children and the elderly, because their immune systems tend to be weaker.

Although rare, inflammation of the brain has the potential to be serious and life threatening. Therefore, early detection and treatment are needed as soon as possible.

Causes of Brain Inflammation

In most cases, inflammation of the brain is caused by a viral infection. This viral infection can directly attack the brain or is called primary encephalitis. However, it can also come from other organs that attack the brain, or it is called secondary encephalitis.

Types of viruses that can cause inflammation of the brain include:

  • Herpes simplex virus, which causes oral herpes and genital herpes , as well as herpes in babies
  • Varicella zoster virus , the cause of chickenpox and shingles
  • Epstein -Barr virus , the cause of mononucleosis
  • Viruses that cause measles ( measles ), mumps ( mumps ), and rubella
  • Viruses from animals, such as rabies and nipah virus
  • SARS-CoV-2 virus ( COVID-19 )

Please note, the above viral infections can be contagious even though encephalitis itself is not contagious. Apart from viruses, inflammation of the brain can also be caused by bacteria or fungi.

Inflammation of the brain or encephalitis is more prone to occur in people with weak immune systems, such as people with HIV or people who are taking immunosuppressive drugs .

Symptoms of Encephalitis

Encephalitis or inflammation of the brain begins with mild flu-like symptoms , such as fever, headache, vomiting, feeling tired, and muscle and joint pain. As it progresses, inflammation of the brain can cause more serious symptoms, such as:

  • Fever up to over 39 o C
  • dazed
  • Hallucinations
  • Unstable emotion
  • Impaired speech, hearing, or vision
  • Weak muscles
  • Paralysis of the face or certain body parts
  • seizures
  • Loss of consciousness

In infants and children, the symptoms of inflammation of the brain are generally not recognized, because they resemble the symptoms of other diseases. Symptoms that can appear are:

  • Nausea and vomiting
  • Loss of appetite
  • The child's body looks stiff
  • A bulge appears on the crown of the head
  • Fussy and often cry

When to see a doctor

Immediately consult a doctor if symptoms of inflammation of the brain appear as mentioned above, or if you experience a severe headache accompanied by a high fever.

Infants and children who are suspected of having symptoms of encephalitis should be immediately taken to the hospital for a doctor's examination. Early treatment of encephalitis needs to be done to prevent further brain damage in children.

HIV sufferers are advised to continue taking antiviral drugs so that their disease can be controlled and not infected with other diseases, such as encephalitis.

Some diseases, such as autoimmune diseases , require long-term immunosuppressive drugs. Discuss with your doctor the benefits and risks of these drugs, as well as how to prevent infection while taking immunosuppressive drugs.

Diagnosis of Encephalitis

Brain inflammation is often difficult to diagnose because it has early symptoms that resemble flu symptoms. In the initial stages of the examination, the doctor will ask about the symptoms followed by a physical examination of the patient.

Furthermore, the doctor will carry out further examinations to determine whether the patient has inflammation of the brain or encephalitis. The follow-up examination is carried out by:

  • MRI or CT scan
    An MRI or CT scan is the first examination a doctor performs to detect inflammation of the brain. This examination can show abnormalities in the brain, such as swelling or tumors that trigger inflammation in the brain.
  • Lumbar puncture
    This examination is carried out to identify the type of virus that causes the infection. In a lumbar puncture examination , the doctor will insert a needle into the spine to take a sample of cerebrospinal fluid for examination in the laboratory.
  • Electroencephalogram (EEG)
    This examination is performed by a doctor to check the electrical activity of the brain and determine the location of the infected brain.
  • Laboratory
    tests Several laboratory tests, such as blood, urine, or sputum tests, may be performed to identify the cause of the infection.
  • Brain biopsy
    This procedure aims to detect the presence of the virus by taking a sample of brain tissue. This procedure is only done if the symptoms are getting worse and the treatment is no longer effective.

Brain Inflammation Treatment

Inflammation of the brain requires treatment in the hospital. The sooner treatment is given, the higher the success rate of the treatment process.

The goal of treating encephalitis is to address the cause, relieve symptoms, and prevent complications. The treatment that the neurologist will give can be in the form of:

Drugs

Most encephalitis is caused by a viral infection, so the main treatment is antiviral drugs , such as acyclovir and ganciclovir . However, these two drugs can only treat certain viruses, such as herpes simplex and Varicella zoster .

Meanwhile, if the infection is caused by bacteria or fungi, the doctor will give antibiotics or antifungal drugs.

The doctor will also provide other medicines that are useful for relieving the symptoms that appear. These types of drugs are:

  • Corticosteroids , to reduce inflammation and pressure inside the head
  • Anticonvulsants, to stop or prevent seizures
  • Paracetamol, to relieve pain and fever
  • Sedatives (sedatives), to provide a calming effect on patients who experience emotional disturbances and get angry easily

The patient will also be given an infusion of fluids and nutrients to prevent dehydration and maintain the nutritional needs of the body. If necessary, the patient will also be given a breathing apparatus.

The length of treatment for inflammation of the brain can last for several days, weeks, to months, depending on the patient's condition.

Special therapy

If inflammation of the brain has affected the brain's ability to remember and understand something, or caused the sufferer to have difficulty speaking or controlling the body, then a rehabilitation program needs to be carried out. Some types of therapy that can be done are:

  • Physical therapy or physiotherapy , to improve muscle strength, body balance, and control motor nerves
  • Speech therapy, to restore the function of the muscles that control speech
  • Occupational therapy, to assist patients in carrying out daily activities
  • Psychotherapy , to help patients control unstable emotions and deal with the personality changes they experience

Complications of Encephalitis

The risk of complications that may occur due to inflammation of the brain depends on the patient's age, the cause of the infection, the severity, and the speed of treatment.

Brain damage caused by encephalitis can last for months or even forever. The location of the damage to the brain can also determine the type of complications that occur.

These complications include:

  • Paralysis
  • Speech and language disorders
  • Hearing and vision impairment
  • Generalized anxiety disorder
  • Memory loss
  • Personality disorders
  • Epilepsy

In severe inflammation of the brain, sufferers can experience coma, even death.

Prevention of Brain Inflammation

The main prevention of encephalitis is vaccination against viruses that cause encephalitis, one of which is the MMR vaccine . The MMR vaccine provides protection against measles, mumps, and rubella, which can cause inflammation of the brain.

In infants and toddlers, MMR immunization should be done twice, namely at the age of 15 months and 5 years. In people who have not received the MMR vaccine, vaccination can be done at any time.

The MMR vaccine is also given when you are going to travel to areas that are prone to infection. In this case, consult your doctor again about the type of vaccine that is right for you.

Apart from immunization, there are some simple steps you can take to prevent transmission of the virus and reduce the risk of encephalitis, namely:

  • Wash your hands frequently , especially before eating and after going to the bathroom
  • Do not share the use of cutlery with others
  • Prevent mosquito bites, by wearing closed clothes or using mosquito repellent lotion
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