Brain Inflammation and what you should know: Encephalitis Awareness Thu , Feb 23

Encephalitis, commonly known as “Brain Inflammation” is a serious neurological condition that affects millions of people worldwide. On World Encephalitis Day, which falls on February 22, we take a closer look at this condition, its causes, symptoms, and treatment options.

Encephalitis, commonly known as “Brain Inflammation” is a serious neurological condition that affects millions of people worldwide. On World Encephalitis Day, which falls on February 22, we take a closer look at this condition, its causes, symptoms, and treatment options.

Encephalitis is a major public health problem in India, with outbreaks occurring frequently in different parts of the country.

According to the National Vector Borne Disease Control Programme (NVBDCP), there were 20,018 cases of acute encephalitis syndrome (AES) and 2,500 deaths reported in India in 2019.

The highest number of cases were reported from the states of Uttar Pradesh, Bihar, and Assam.

The southern states of India, including Tamil Nadu, Karnataka, Kerala, and Andhra Pradesh, have reported cases of encephalitis in the past.

According to a study published in the Journal of Neurosciences in Rural Practice, there were 1,302 cases of acute encephalitis syndrome reported in Karnataka between 2010 and 2015, with a case fatality rate of 13.21%.

Another study published in the Indian Journal of Medical Research reported 170 cases of Japanese encephalitis (JE) in Tamil Nadu between 2010 and 2015, with a case fatality rate of 22.9%.

The most common cause of encephalitis is viral infection, such as the herpes simplex virus, which is responsible for about half of all cases of encephalitis in the United States. Other viruses that can cause encephalitis include:

• Japanese encephalitis virus
• Varicella-zoster virus
• Dengue fever
• Enterovirus
• West Nile virus
• Measles virus
• Mumps virus
• Rabies virus
• In rare cases, encephalitis can be caused by bacterial infections, such as Listeria (brainstem encephalitis) Lyme disease or tuberculosis.
• Autoimmune disorders, such as lupus or multiple sclerosis, can also cause encephalitis.
• Miller Fischer syndrome/ Bickerstaff Brainstem encephalitis is a continuum of immune medicated disorders that affect the lower part of the brain and can be associated with generalized neuromuscular weakness.
• Litchi fruit toxicity: methylene cyclopropyl-glycine (MCPG), known to be fatal by causing encephalitis-related deaths when consumed by malnourished kids.

The symptoms of encephalitis can vary widely depending on the underlying cause of the condition. Some common symptoms of encephalitis include:

• Fever
• Headache
• Stiff neck
• Confusion
• Seizures
• Personality changes
• Movement disorders like chorea, dystonia, parkinsonism
• Loss of consciousness
• In severe cases, encephalitis can cause long-term and permanent neurological damage (post-encephalitic parkinsonian sequelae) or even death.

If you suspect that you or a loved one may have encephalitis, it is important to seek medical attention immediately. Timely medical attention and intervention is mandatory to prevent long term neurological sequalae. Your doctor will perform a physical exam and may order a variety of tests to help diagnose the condition, such as blood tests, brain scans, and very importantly spinal taps to analyse the cerebrospinal fluid (CSF).

The treatment of encephalitis will depend on the underlying cause of the condition. If the cause is viral, antiviral medications may be prescribed to help fight the infection. If the cause is bacterial, antibiotics may be necessary. In some cases, hospitalization may be required to provide supportive care, such as intravenous fluids or respiratory support.

The best way to prevent encephalitis is to avoid exposure to viruses (most infective encephalitis in India is cause by arboviruses which are transmitted by mosquito bite).and other infections that can cause the condition. This may include practicing good hygiene, such as washing your hands frequently and avoiding contact with people who are sick. Vector control measures both at individual and at community (policy guided) levels are crucial.

If you are traveling to an area where encephalitis is common, such as certain parts of Asia or Africa, it may be necessary to take additional precautions, such as getting vaccinated or taking antimalarial medications.

It is being increasingly recognized that certain forms of encephalitis are caused by aberrant body immune response that tend to damage the brain and resulting in a myriad of clinical features. This group of disorders are being increasing recognized off late. Some of these disorders (autoimmune encephalitis) tend to affect younger individuals and can lead to seizures, psychiatric and behavioural dysfunction with dysautonomia. Several anecdotal events like the “Witch Hunt of Salem” and reports of “demonic possession” are now believed to have been caused by these disorders. A mention about Susannah Cahalan (and her award-winning book “Brain on Fire”).

The other group of disorders which are being increasingly recognized off late are the paraneoplastic encephalitis which is a consequence of cancer elsewhere in the body. Interestingly these disorders present with neurological symptoms even before the clinical features of the cancer manifest. The pattern of antibody in the blood or the CSF and PET imaging helps identify the cancer in most of them.

Litchee fruit toxicity in malnourished kids in Muzaffarnagar is linked to low blood sugar levels. More than 400 children have died with severe convulsions and fever after eating litchee and going to bed on an empty stomach.

Children who are well-nourished do not get sick from Litchi, however, undernourished children who are under-nourished and had eaten Litchi fruit earlier that day will only get sick from Litchi. This can be prevented by avoiding undernourishment in young children and ensuring a healthy and safe environment for them.

Encephalitis is a serious neurological condition that can have serious long-term consequences if left untreated. If you or a loved one is experiencing symptoms of encephalitis, it is important to seek medical attention immediately. By understanding the causes, symptoms, and treatment options for encephalitis, you can take steps to protect yourself and your family from this potentially life-threatening condition.

The care team at MGM Healthcare 

We at MGM Healthcare have doctors who specialize in the brain and nervous system (neurologists), brain imaging (neuroradiologists) and infectious diseases to provide comprehensive care for people with encephalitis. Neuro-Infectious Diseases Group specialists are frequently involved in care.

With all of this subspecialized expertise in one place, focused on your care, you’re not just getting one opinion — care is discussed among the team, appointments are scheduled in coordination, and highly specialized encephalitis experts work together to determine what’s right for your loved ones or yourself.