A complex puzzle

No two cases of encephalitis are identical, which makes diagnosis difficult and often delayed. Some patients may present with just a handful of symptoms, which often mimic the flu. It's common for patients to worsen before a clinician considers encephalitis as a possible diagnosis. 

Encephalitis is one of the most challenging entities for physicians to diagnose and manage because:

• Patients present with variable manifestations
• There are countless causes
• There are no predicting factors
• Imaging and other testing is often inconclusive
• Diagnostic and treatment protocols lack standardization
• The field of research remains limited
• Encephalitis is relatively rare
• Awareness and advocacy at the medical level is limited

Diagnostic approaches

Clinicians use a variety of diagnostic tools based on the patient's symptoms and severity of decline. These are the more common approaches:

• Blood work or urine and stool tests to identify organisms that could be causing infection
• Brain MRI or CT to reveal swelling of the brain or rule out another condition, such as a tumor
• Lumbar puncture to test for inflammation in the brain
• Electroencephalogram (EEG) to record the brain's electrical activity or detect seizures
• Physical examination
• History of vaccines, previous diagnoses, recent travel, exposure to mosquitoes/ticks
• Brain biopsy to run tests on a small amount of brain tissue (rarely performed)