Therapy and prognosis

The therapy of acute viral encephalitis depends on the pathogen. There is no specific therapy against those viruses that cause even our simple viral meningitis, such as coxsackie, echo or myxoviruses (e.g. the influenza (flu) virus, parainfluenza and mumps virus), and the same recommendations apply as for simple viral meningitis: for the other, much more dangerous forms of viral encephalitis discussed below, so-called virustatics are usually given. In most cases, virustatics inhibit enzymes that the viruses use to multiply.

The range of drugs has been constantly expanding in recent years and more and more well-tolerated antiviral substances are coming onto the market (e.g. Tamiflu). In severe cases, intensive medical treatment may also be necessary: Respiratory and cardiovascular functions (blood pressure, pulse, possibly artificial respiration) as well as the water and salt balance are monitored. If necessary, the cerebral pressure can also be measured directly and continuously by inserting a pressure probe directly into the ventricle system of the brain.

Bed rest
Painkillers (e.g. paracetamol)
Antipyretic measures

How contagious is viral encephalitis?

Viral encephalitis can be contagious in different ways depending on the virus that causes the encephalitis. In general, it can be said that viral encephalitis is not a common disease. However, there are more vulnerable age groups, such as infants or elderly people, who are more likely to develop viral encephalitis.

If a person in the immediate vicinity is affected, the infection can occur very easily, so it is essential that distance and hygiene measures are observed. For example, if it is viral encephalitis caused by measles, it is naturally more contagious among children and, if a child is affected, it can be easily transmitted. TBE, which is transmitted by ticks, is in turn more widespread in forest areas than, for example, in a coastal region.General information about virus infections can be found at virus infection

Diagnosis of acute viral encephalitis

As in acute lymphocytic (simple) viral meningitis, the cerebrospinal fluid (liquor) collected shows almost normal findings. Here, the examination for antibodies is most important, especially IgM antibodies, because these indicate an acute (fresh) inflammation. Often, however, the pathogen is not reliably detectable.

With the help of PCR (polymerase chain reaction) the genes of viruses of the herpes group can be detected or excluded. In this way, early treatment can prevent a dangerous progression. The EEG (electroencephalogram) also provides information about a defined and general inflammatory event in the brain.

Here, electrodes are applied to the scalp. They conduct the electrical brain waves. In contrast to the healthy brain, the waves and curves of the EEG are always different in acute viral encephalitis.

Imaging procedures such as CT (computed tomography) and MRI of the head (also known as magnetic resonance tomography, “nuclear spin”), which take layered images of the head, are also used. They often only show a general, uncharacteristic swelling of the brain. They are mainly used to rule out other causes for the symptoms, e.g. a cerebral hemorrhage that would require immediate surgery, a brain tumor or sinus vein thrombosis.

Only the dangerous herpes simplex encephalitis has a characteristic image of the brain in the MRI. The MRI is particularly well suited to detect viral encephalitis. In it, signs of viral encephalitis can be made particularly visible, much earlier than in a CT examination.

Particularly characteristic are early condensed areas in the temporal and frontal lobes on both sides of the brain. These are the areas laterally above the ear and behind the forehead. Dorf, brightened areas are found in the MRI image that describe an inflammation of the tissue. The swollen brain matter displaces the surrounding areas to the side, often causing the cerebral fluid spaces to be compressed. In addition, in these inflamed areas, no clear distinction can be made between the cortex and medulla of the brain because the border between them is optically blurred.