Which Is More Serious: Encephalitis or Meningitis?

Meningitis is an infection of the membrane surrounding the brain and spinal cord. Encephalitis is brain inflammation. Meningitis and encephalitis are both medical emergencies that require immediate treatment.

Meningitis and encephalitis are medical emergencies that require immediate treatment. Meningitis is an infection of the membrane that surrounds the brain and spinal cord. Encephalitis is an inflammation of the brain. Encephalitis and meningitis have various causes, including viruses, bacteria, fungal infections, and parasites.

Individual cases of meningitis and encephalitis can vary greatly depending on their cause and severity. Therefore, it is not clear which is more serious and dangerous overall. Viral encephalitis and bacterial meningitis tend to be especially dangerous. All cases of meningitis and encephalitis are serious and need emergent treatment.

What is encephalitis?

Encephalitis is an inflammation of the brain. It's caused by either an autoimmune response, which is when your body attacks your immune system, or an infection. Because of the inflammation, the brain starts to swell. The swelling can cause symptoms like headache, light sensitivity, stiff neck, seizures, and confusion. Out of every 100,000 people in the U.S., 10 to 15 develop encephalitis every year. It usually affects younger people, but anyone can get it. 

What is meningitis?

Meningitis happens when there is a swelling in the membrane that covers the brain and spinal cord. It is most often caused by a viral or bacterial infection of the fluid that surrounds the brain and spinal cord. However, it's sometimes caused by cancer, injury, drugs, or other infections. It's important to know what caused it because the treatment is different depending on the cause of the inflammation. 

Symptoms of encephalitis

Acute Encephalitis starts with symptoms that get worse over the course of a few days to a few weeks. Symptoms of infectious encephalitis often start out like the flu or a headache and then progress to problems with thinking and reasoning. Autoimmune encephalitis progresses over several weeks. The symptoms of encephalitis depend on what part of the brain is inflamed and the associated antibody if it is an autoimmune reaction. 

Physical symptoms of encephalitis can include:

• Headache
• Seizures 
• Fever
• Light sensitivity
• Movement disorders
• Sound sensitivity
• Neck stiffness
• Loss of consciousness
• Weakness or paralysis in the arms or legs
• Double vision
• Impaired hearing or speech
• Coma in severe cases

Cognitive symptoms of encephalitis can include:

• Disorientation and confusion
• Sleepiness
• Anxiety
• Irritability
• Psychosis 
• Hallucinations
• Impaired cognitive function, or difficulty thinking
• Memory loss
• Other behavioral changes

Symptoms of meningitis 

The most common symptoms of meningitis include:

• Fever
• Headache
• Nausea and vomiting
• Light sensitivity
• Stiff neck
• Joint aches
• Confusion
• Drowsiness 
• Seizures

Children's meningitis symptoms can include:

• High-pitched cry
• Fever
• Blotchy, pale skin
• Loss of appetite
• Fussiness
• Vomiting
• Backache
• Difficulty waking up

Causes of encephalitis 

Encephalitis is caused by an infection or an autoimmune response. 

In about 30–40% of cases, the cause is never found. Infectious encephalitis is caused by a virus such as the herpes simplex virus types 1 and 2, as well as many others. Bacteria, fungus, and parasites can also cause encephalitis but not often. 

Autoimmune encephalitis is caused by the body's immune system attacking the brain. These causes are not well understood but can happen with tumors and some infections. 

Causes of meningitis 

Meningitis is usually caused by a virus or bacteria. 

It is more commonly caused by a virus, which can be spread by coughing, sneezing, or poor hygiene. Sometimes viral meningitis is caused by insects, such as ticks and mosquitoes, spreading viruses. 

Bacterial meningitis is rarer and more deadly than viral meningitis. It can be caused by many different types of bacteria. Meningitis can also be caused by a fungus or tuberculosis, but that is uncommon. 

Tests for encephalitis

If you think you have symptoms of encephalitis, your doctor will listen to your symptoms and do a physical exam. You may need to have some other tests performed as well, including: 

• Magnetic resonance imaging (MRI) scan of the brain
• Computerized tomography (CT) of the brain
• Lumbar puncture (spinal tap), which is a sample of the fluid around your brain and spinal cord
• Electroencephalogram (EEG) to check for seizures
• Blood tests
• Urine or stool tests
• Sputum test, which is a test of the mucus that you cough up

Test for meningitis

Diagnosing meningitis usually involves a physical exam and medical history. Tests for meningitis can include: 

• Lumbar puncture (spinal tap)
• Blood tests
• CT scan

Treatments of encephalitis 

It's important to get treated early for encephalitis and to treat the underlying cause. Your doctor will work with a team of specialists to figure out what is causing the encephalitis and how to best treat it. Treatment for encephalitis can include: 

• Antiviral medications
• Antibiotics
• Medicines to control seizures

Autoimmune encephalitis is often treated with:

• Immunotherapies such as steroids 
• Intravenous (IV) antibodies 
• Plasma exchange

Treatments of meningitis 

Treatment for meningitis will depend on the cause. 

• Bacterial Meningitis: Intravenous (IV) antibiotics are used to treat meningitis caused by a bacterial infection. It's important to start treatment early. Steroids may be used to treat children, but aren't as effective in adults. 
• Viral Meningitis: The main aim of treatment for viral meningitis is to relieve the symptoms. Other than the herpes simplex virus, there is no specific medicine to treat the viruses that cause meningitis. Sometimes antiviral medicines can treat the underlying virus. 

If you have either type of meningitis, you will benefit from resting in a dimly lit room and taking medicine to help with fever and headache. You should avoid aspirin if you have meningitis.