MEDICAL CONDITIONS
Encephalitis and Meningitis
What is encephalitis?
Encephalitis is an inflammation of the brain. There are many types of encephalitis, most of which are caused by infection with viruses.
What are symptoms of encephalitis?
Symptoms of encephalitis include sudden fever, headache , vomiting, abnormal visual sensitivity to light, stiff neck and back, confusion, drowsiness, clumsiness, unsteady gait, and irritability. Symptoms that require emergency treatment include loss of consciousness, poor responsiveness, seizures, muscle weakness, sudden severe dementia , memory loss, withdrawal from social interaction, and impaired judgement.
Anyone experiencing symptoms of encephalitis should see a doctor immediately.
What is meningitis?
Meningitis is an inflammation of the membranes (called meninges) that surround the brain and spinal cord. Meningitis may be caused by many different viruses and bacteria, or by diseases that can cause inflammation of tissues of the body without infection (such as systemic lupus erythematosus and Behcet's disease).
What are symptoms of meningitis?
Symptoms of meningitis, which may appear suddenly, often include high fever, severe and persistent headache, stiff neck, nausea, and vomiting. Changes in behavior such as confusion, sleepiness, and difficulty waking up are extremely important symptoms and may require emergency treatment. In infants symptoms of meningitis may include irritability or tiredness, poor feeding and fever.
Some types of meningitis can be deadly if not treated promptly. Anyone experiencing symptoms of meningitis should see a doctor immediately.
What is encephalomyelitis?
Encephalomyelitis is the term used to refer to inflammation of both the brain and spinal cord. Encephalomyelitis can be caused by a variety of conditions that lead to irritation of the brain and spinal cord. Among the common causes of encephalomyelitis are viruses which infect the nervous tissues. (An example of a type of virus that can cause encephalomyelitis is the herpes zoster virus.) Persons with encephalomyelitis can exhibit combinations of the various symptoms of either encephalitis or meningitis.
How are encephalitis and meningitis diagnosed?
Encephalitis or meningitis are suggested when the symptoms described above are present. The doctor diagnoses encephalitis or meningitis after a careful examination and testing. The examination includes special maneuvers to detect signs of inflammation of the membranes that surround the brain and spinal cord (meninges).
Tests that are used in the evaluation of individuals suspected of having encephalitis or meningitis include blood counts, brain scanning (such as MRI scan), and spinal fluid analysis.
A lumbar puncture is the most common method of obtaining a sample of the fluid in the spinal canal (the cerebrospinal fluid or CSF) for examination. A lumbar puncture (an LP) is the insertion of a needle into the fluid within the spinal canal. It is termed a "lumbar puncture" because the needle goes into the lumbar portion (the "small") of the back. (Less commonly, spinal fluid can also be obtained from other levels of the spine.)
The diagnosis is confirmed by abnormal spinal fluid results.
What is the treatment of encephalitis and meningitis?
Antiviral medications may be prescribed for encephalitis caused by the herpes virus or other severe viral infections. Antibiotics are prescribed for bacterial infections. Anticonvulsants are used to prevent or treat seizures. Corticosteroids are used to reduce brain swelling and inflammation. Sedatives may be needed for irritability or restlessness. Over-the-counter medications may be used for fever and headache.
Individuals with bacterial meningitis are usually hospitalized and treated with antibiotics intravenously. Antiviral drugs may also be prescribed.
What is the outlook (prognosis) for patients with encephalitis or meningitis?
The prognosis for encephalitis varies. Some cases are mild, short and relatively benign and patients have full recovery. Other cases are severe, and permanent impairment or death is possible. Meningitis can lead to permanent damage to the nervous system and can cause hydrocephalus . The acute phase of encephalitis may last for 1 to 2 weeks, with gradual or sudden resolution of fever and neurological symptoms. Neurological symptoms may require many months before full recovery.
With early diagnosis and prompt treatment, most patients recover from meningitis. Viral meningitis cases are usually self-limited to 10 days or less. However, in some cases, the disease progresses so rapidly that death occurs during the first 48 hours, despite early treatment.
Is meningitis contagious?
Yes. Especially some forms of bacterial meningitis are contagious. The bacteria are spread through the exchange of respiratory and throat secretions (i.e., coughing, kissing). Fortunately, none of the bacteria that cause meningitis are as contagious as conditions like the common cold or flu, and they are not spread by casual contact or by simply breathing the air where a person with meningitis has been. However, sometimes the bacteria that cause meningitis have spread to other people who have had close or prolonged contact with a patient with meningitis caused by Neisseria meningitidis (also called meningococcal meningitis) or Hib. People in the same household or day- care center, or anyone with direct contact with a patient's oral secretions (such as a boyfriend or girlfriend) would be considered at increased risk of acquiring the infection. People who qualify as close contacts of a person with meningitis caused by N. meningitidis should receive antibiotics to prevent them from getting the disease. (Antibiotics for contacts of a person with Hib meningitis disease are no longer recommended if all contacts 4 years of age or younger are fully vaccinated against Hib disease.)
Are there vaccines against meningitis?
Yes. There are vaccines against Hib and against some strains of N. meningitidis and many types of Streptococcus pneumoniae.
The vaccines against Hib are considered very safe and highly effective. By age 6 months of age, every infant should receive at least 3 doses of an Hib vaccine. A fourth dose ("booster") should be given to children between 12 and 18 months of age.
There is also a vaccine that protects against four strains of N. meningitidis, but it is not routinely used in the United States. It is not effective in children under 18 months of age. It is sometimes used to control outbreaks of some types of meningococcal meningitis in the United States.
Although large epidemics of meningococcal meningitis do not occur in the United States, some countries experience large, periodic epidemics. Overseas travelers should check to see if meningococcal vaccine is recommended for their destination. Travelers should receive the vaccine at least 1 week before departure, if possible.
A vaccine to prevent meningitis due to S. pneumoniae (also called pneumococcal meningitis) can also prevent other forms of infection due to S. pneumoniae. The pneumococcal vaccine is not effective in children under 2 years of age but it is recommended for all persons over 65 years of age and younger persons with certain chronic medical problems. - Encephalitis is an inflammation of the brain.
- Meningitis is an inflammation of the membranes (called meninges) that surround the brain and spinal cord.
- Anyone experiencing symptoms of encephalitis or meningitis should see a doctor immediately.
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