The diagnostic process begins with a detailed medical history and physical examination to assess the patient’s symptoms, recent illnesses, travel history, vaccination status, and potential exposure to infectious agents.

1. Neurological Examination:A thorough neurological examination is conducted to evaluate the patient’s mental status, motor and sensory functions, reflexes, and coordination. This helps identify any focal neurological deficits that may indicate specific areas of the brain being affected.

2. Imaging Studies:Imaging studies such as magnetic resonance imaging (MRI) or computed tomography (CT) scans are essential tools in diagnosing encephalitis. MRI is particularly useful as it provides detailed images of brain structures, revealing areas of inflammation, swelling, or other abnormalities. MRI can help distinguish encephalitis from other conditions with similar symptoms, such as brain tumours or strokes.

3. Lumbar Puncture (Spinal Tap):A lumbar puncture is often performed to analyse the cerebrospinal fluid (CSF) surrounding the brain and spinal cord. CSF analysis can reveal elevated white blood cells, proteins, and other markers of inflammation, as well as identify infectious agents like viruses, bacteria, or fungi. This procedure is crucial for confirming the diagnosis and identifying the cause of encephalitis.

4. Laboratory Tests: Blood tests are conducted to check for markers of infection or inflammation, such as complete blood count (CBC), C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR). Specific serological tests can detect antibodies against common viruses that cause encephalitis, such as herpes simplex virus (HSV), varicella-zoster virus (VZV), and West Nile virus. Polymerase chain reaction (PCR) tests can also be used on CSF samples to detect viral DNA or RNA.

5. Electroencephalography (EEG):An EEG may be performed to monitor the electrical activity of the brain. Abnormal brain waves can suggest encephalitis and help differentiate it from other neurological conditions. EEG is particularly useful in detecting seizures or other abnormalities in brain function that are common in encephalitis patients.

6. Biopsy:In rare cases where the diagnosis remains uncertain, a brain biopsy may be necessary. This involves obtaining a small sample of brain tissue for microscopic examination to identify the specific cause of inflammation.

Combining these diagnostic tools allows medical professionals to accurately diagnose encephalitis, determine its cause, and develop an effective treatment plan.

Treating encephalitis involves a multidisciplinary approach that aims to address the underlying cause of the inflammation, manage symptoms, and prevent complications. The treatment plan is tailored to the specific type and severity of encephalitis, as well as the patient’s overall health.

1. Antiviral and Antibacterial Treatments: If encephalitis is suspected to be caused by a viral infection, antiviral medications are often administered. For example, acyclovir is commonly used to treat herpes simplex virus (HSV) encephalitis, one of the most severe forms of the disease. In cases where bacterial infection is suspected, broad-spectrum antibiotics may be given until the specific pathogen is identified through laboratory tests, at which point targeted antibiotics can be prescribed.

2. Anti-inflammatory and Immunosuppressive Therapies: In cases of autoimmune encephalitis, where the body’s immune system mistakenly attacks brain tissue, immunosuppressive treatments such as corticosteroids, intravenous immunoglobulins (IVIG), or plasmapheresis (plasma exchange) are used to reduce inflammation and immune response. These treatments help alleviate symptoms and prevent further damage to the brain.

3. Symptomatic Treatment and Supportive Care:Managing symptoms is a crucial aspect of encephalitis treatment. Anticonvulsant medications may be prescribed to control seizures, while antipyretics can help manage fever. Pain relievers are used to alleviate headaches and other discomforts. Additionally, patients may require supportive care, including hydration, nutrition, and respiratory support, particularly in severe cases where consciousness or autonomic functions are impaired.

4. Preventive Measures: Preventive measures can also be important, particularly for those at high risk of certain types of encephalitis. Vaccinations, such as those for measles, mumps, rubella (MMR), and Japanese encephalitis, can prevent infections that might lead to encephalitis. For individuals with weakened immune systems, prophylactic antiviral or antibacterial medications may be considered.

By addressing both the immediate symptoms and the underlying causes of encephalitis, medical professionals aim to minimise brain damage, reduce long-term neurological deficits, and support patients in their recovery journey.