Treatment during the acute phase
Treatment options during the acute phase are limited and depend on the cause. In most cases of suspected infectious encephalitis, the treating physician will immediately administer antivirals (usually acyclovir).
These are the the most common treatments approaches used in the acute phase:
These are the the most common treatments approaches used in the acute phase:
- Antivirals to treat viral causes, particularly herpes simplex virus and varicella zoster virus
- Antibiotics to treat bacterial causes
- Anti-fungals to treat fungal causes (rare)
- Medications to control seizures caused by encephalitis (occurs in ~43% of patients)
- Steroid injections if encephalitis is linked to the chickenpox virus
- A breathing tube, urinary catheter, or feeding tube may be necessary if the patient loses consciousness
Treatment during the chronic phase
After the acute phase of encephalitis has passed, many survivors wonder, “Is this as good as it gets?” They are left to recover from an acquired brain injury: their cognition is impaired; their speech is impacted; their balance is off. And their sense of well-being seems elusive. Of course, rest, determination, and patience are important factors in recovery. However, few resources point patients and their caregivers to the possibilities for, and value of, comprehensive rehabilitation.
There are a number of rehabilitation options that can be of benefit to survivors, including physical therapy, occupational therapy, speech therapy, cognitive therapy and behavioral therapy. It is believed that these therapies are most effective when engaged in the months immediately following the acute phase of the illness. However, many survivors see amazing benefits even years after the inflammation is gone.
rehabilitative strategies
- Physical Therapy with a physiotherapist helps patients restore and maintain their mobility. For encephalitis patients, this might include re-learning how to walk, improving balance to prevent falls, addressing dizziness, headache/pain and fatigue, and increasing cardiovascular fitness/endurance.
- Occupational Therapy with an occupational therapist helps patients return to their pre-encephalitis activities (usually work or school) when there are physical and cognitive changes. The goal is to maximize independence, learn how to use adaptive equipment, and maximize range of motion.
- Speech Therapy with a speech language pathologist helps patients improve their ability to exchange thoughts, ideas, wants, and needs with others. Programs can be designed to work on skills such as articulation, fluency, producing sounds, understanding the meaning of words, and combining words or ideas to express a message.
- Cognitive Therapy with a speech language pathologist helps patients remediate impairments in thinking skills. Strategies can be developed to support successful communication and address deficits in attention, memory, executive functioning, and verbal reasoning.
- Psychological Therapy with a psychologist, therapist, or counsellor helps patients and caregivers alike process through the emotional impact of encephalitis. While many endure medical trauma, PTSD, and complex emotions in the wake of this life-changing illness, psychological therapy is often overlooked as a means of aiding recovery. Common experiences faced by encephalitis survivors and caregivers include emotional dysregulation, difficulties with coping, feelings of isolation, loss of identity, depression, and anxiety. Psychological therapy is often a helpful strategy for addressing these challenges.