Encephalitis is irritation and swelling ( inflammation) of the brain, most often due to infections.
Causes, incidence, and risk factors
Encephalitis is a rare condition. It occurs more often in the first year of life and decreases with age. The very young and the elderly are more likely to have a severe case.
Encephalitis is most often caused by a viral infection. Many types of viruses may cause it. Exposure to viruses can occur through:
- Breathing in respiratory droplets from an infected person
- Contaminated food or drink
- Mosquito, tick, and other insect bites
- Skin contact
Different viruses will occur in different locations. Many cases will tend to cluster in a certain season.
Encephalitis caused by the herpes simplex virus is the leading cause of more severe cases in all ages, including newborns.
A number of viruses for which there is now a vaccine may also cause encephalitis. These include:
- Polio
- Varicella (chickenpox)
Other viruses that cause encephalitis include:
- Adenovirus
- Coxsackievirus
- Eastern Equine Encephalitis Virus
- Echovirus
The virus causes inflammation of brain tissue. The brain tissue swells (cerebral edema), which may destroy nerve cells, cause bleeding in the brain (intracerebral hemorrhage), and brain damage.
Other causes of encephalitis may include:
- An allergic reaction to vaccinations
- Autoimmune disease
- Bacteria, such as Lyme disease,syphilis, and tuberculosis
- Parasites such as roundworms, cysticercosis, and toxoplasmosis in AIDS patients and other people who have a weakened immune system
- The effects of cancer
Symptoms
Some patients may have symptoms of a cold or stomach infection before encephalitis symptoms begin.
When a case of encephalitis is not very severe, the symptoms may be similar to those of other illnesses, including:
- Fever that is not very high
- Mild headache
- Low energy and a poor appetite
Other symptoms include:
- Confusion, disorientation
- Irritability or poor temper control
- Stiff neck and back (occasionally)
- Vomiting
Symptoms in newborns and younger infants may not be as easy to recognize:
- Body stiffness
- Irritability and crying more often (these symptoms may get worse when the baby is picked up)
- Poor feeding
- Soft spot on the top of the head may bulge out more
- Vomiting
Emergency symptoms:
- Loss of consciousness, poor responsiveness, stupor, coma
- Severe headache
- Sudden change in mental functions:
- "Flat" mood, lack of mood, or mood that is inappropriate for the situation
- Impaired judgment
- Inflexibility, extreme self-centeredness, inability to make a decision, or withdrawal from social interaction
- Less interest in daily activities
- Memory loss (amnesia), impaired short-term or long-term memory
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