Acute Encephalitis

Acute encephalitis is an inflammatory condition of the central nervous system. It is a complex and severe disease. Acute encephalitis can be caused by a wide variety of conditions, including:

  • Bacterial or viral infection in the brain
  • Ingestion of toxic substances
  • Complication of an infectious disease
  • Complication of an underlying malignancy

Symptoms of acute encephalitis can vary, depending on which part of the brain that is most affected. A few symptoms that may be common in patients with acute encephalitis include (but are not limited to):

  • Fever
  • Headache
  • Sensitivity to light or sound
  • Confusion
  • Poor memory/memory loss
  • Disorientation
  • Irritability
  • Anxiety
  • Seizures
  • Weakness or numbness of arm or leg

Diagnostic and Therapeutic Approaches

The Johns Hopkins Encephalitis Center is an inpatient unit focusing on patients with newly emerging symptoms. We feel that we have the best opportunity to make a difference in patients who are within 7-10 days of symptom onset (ideally within 3 days) using novel diagnostic tools and therapies.

current methods involve a multipronged approach. These methods include:

  1. Establishment of a rational set of diagnostic guidelines for the investigation of patients with encephalitis. Overall, the use of standardized guidelines and algorithms has been shown to reduce morbidity and mortality in other fields of medicine, and we are investigating whether our guidelines will improve outcomes in patients with encephalitis.
  2. Use of advanced neuro-critical care diagnostic and therapeutic modalities to limit brain damage in the acute setting. Seizures, for example, are a major cause of morbidity in encephalitis patients in the acute setting. We are using continuous electrical monitoring of patients’ brains and aggressive anti-epileptic strategies to limit seizure activity. Additional approaches include cutting edge medical and surgical techniques to monitor and treat the brain swelling that accompanies encephalitis, as well as comprehensive ventilatory and nutritional support for such patients.
  3. Methods to identify new organisms that cause encephalitis. Over 60% of the time, the specific cause of encephalitis cannot be determined. We are working with several groups to identify novel pathogens that cause encephalitis. Identifying these novel organisms is the first step toward developing effective treatments.

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