Encephalitis is inflammation (means response given by the body to any sort of injury to cells) of the brain. It is most often caused by viral infections but can have many other reasons apart from infection. It can lead to fever, confusion, seizures, and altered consciousness. encephalitis is commonly known as Brain fever.
Meningitis is inflammation of the protective membranes around the brain and spinal cord, typically caused by bacterial and less likely viral infections. There are some rare other causes apart from infections. Meningitis does not affect brain as such, unless complicated. Common symptoms of meningitis are as below.
Common causes include viral infections like herpes simplex, Japanese encephalitis. These are neurotropic viruses (Meaning only affects neurological system). Some other viruses like dengue, enterovirus, Varicella zoster, arbovirus, HIV etc can affect other systems in body along with brain. There are some rare viruses like Rabies, Cytomegalovirus, Epstein bar virus also cause encephalitis. Autoimmune (your own body attacks your own brain cells) encephalitis is often seen in children and adolescent population as a common cause. Some vaccine preventable diseases like Measles, mumps, Rubella are also known to cause encephalitis.
Meningitis is more often caused by Bacterial infection. Very rarely viruses would cause meningitis. Common causes of viral meningitis are mumps and Enterovirus. Commonly known bacteria causing meningitis are Pneumococcus, H. Influenzae, Meningococcus, E coli etc. Other rare causes like parasites, fungi are known to cause meningitis especially in children with weakened immune system. Uncommon causes like drugs, cancer and certain other systemic disorders like rheumatoid arthritis, Lupus can lead to meningitis.
Investigations include blood tests, MRI/CT scans, and lumbar puncture to analyze cerebrospinal fluid.
A lumbar puncture (spinal tap) is a test to collect spinal fluid for diagnosing cause of meningitis or encephalitis. It is a test where fluid is collected from covering over spinal cord. Needle is introduced through space between 2 bones of your spine to collect fluid for analysis. (For details read blog on Lumbar puncture)
While brain imaging can support diagnosis, lumbar puncture remains the gold standard for confirming meningitis or encephalitis. The information it provides is not provided by any other investigation.
With early diagnosis and proper treatment, many children recover fully. However, delayed treatment can lead to complications like seizures or developmental issues.
Meningitis:
Majority of meningitis are treatable with antibiotics.
Different bacteria cause meningitis at different ages.
Choice of antibiotic by far decided by identified bacteria.
It is recommended that diagnosis of meningitis is done sooner after suspicion of diagnosis because
Different bacteria have different duration of treatment and it varies from 7 days to 21 days
If bacterial identification is delayed then treatment would be compromised
Viral meningitis needs only symptomatic management
Meningitis caused by parasites and fungi require different medications for very prolonged duration
TB meningitis is a treatable cause of meningitis requires prolonged duration of treatment from 9-12 months
Encephalitis:
Encephalitis is mainly caused by Viruses
There are very few treatable viruses like herpes group of viruses and flu virus
Treatment of viral encephalitis by far remains symptomatic
In the initial phase of infection, symptoms like coma, seizures are prominent. Oxygen & Ventilatory support, fever control, seizure control, management of issues related to other systems in body and nutritional care remains the base of treatment
As the initial symptomatic phase is over, body tries to recover. During the process of recovery various therapies like physiotherapy, oro-motor therapy & vision therapy are done to aid recovery. This phase of treatment is called rehabilitation.
Some of the encephalitis recover partially with permanent neurological sequel.
Anti seizure medications are required to be continued on follow up
Autoimmune encephalitis requires completely different modality of treatment and are treatable.
Yes. Some form of encephalitis and meningitis can be prevented by vaccinating your children against these diseases. Vaccine are available against following viruses and bacteria: Measles, Mumps, Rubella (MMR), Varicella, Japanese encephalitis Pneumococcus, Meningococcus, H. Influenzae, COVID, Influenza or flu virus.
Mosquito control and prevention of bites prevents many causes of mosquito born encephalitis.
