Encephalitis and cerebral palsy
What is encephalitis?
Encephalitis is an inflammation of the brain. This inflammation can have various causes but the most common is infection arising from a virus. The viruses which have the potential to enter the central nervous system (the brain and the spine) include the herpes simplex virus, the measles virus, the varicella virus (chickenpox) and the rubella virus (German measles). Rarer causes of encephalitis include bacterial and fungal infections or where there is a malfunctioning of the immune system (autoimmune encephalitis) which causes the body’s immune system attacks the brain.
The symptoms of encephalitis can include fever, headache, lethargy and at the later stages of encephalitis, confusion, problems with speech, problems with memory and epilepsy. In babies and small children the symptoms can be less specific and include irritability, sleepiness, stiffness and later seizures.
If encephalitis is not controlled it will cause damage to brain cells which can lead to serious injury and disability, including cerebral palsy.
How is encephalitis diagnosed?
There is no single definitive test for encephalitis. Various investigations and tests are used to detect markers of brain inflammation in a patient showing potential symptoms. An MRI or CT scan can allow doctors to review imaging of the brain to check for signs of inflammation. A lumbar puncture (where a sample of spinal fluid is taken from around the spinal cord) can sometimes reveal abnormalities which are consistent with encephalitis. Blood tests can be used to check for signs of infection and/or an electroencephalogram (EEG) is sometimes used to record electrical activity in the brain to detect seizure activity.
How is encephalitis treated?
The treatment for encephalitis depends on the underlying cause of inflammation. Because it can take time to diagnosis an underlying cause for the encephalitis, treatment is usually started empirically (i.e. before a firm diagnosis is made). This is because the earlier appropriate treatment is given, the lower the risk of a brain injury developing.
In order to treat viral encephalitis, anti-viral drugs are used to try and stop the inflammation. Aciclovir is one such anti-viral drug which is used to treat Herpes Simplex Encephalitis (the most common virus causing encephalitis).
In order to treat bacterial causes for encephalitis, antibiotics are prescribed and for fungal causes, anti-fungal treatments are used. Finally, in cases of the autoimmune encephalitis, drugs may be used to suppress the immune system.
Patients might also receive other drugs such as steroids (to reduce inflammation), diuretics (to reduce pressure inside the head), and anticonvulsant drugs to control seizures.
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Encephalitis client story
The cerebral palsy team at Leigh Day, is currently investigating a case on behalf of a child who contracted herpes simplex virus when he was just three weeks old.
Our client was taken to hospital by his mother when she became concerned about his lethargy and a series of slight twitches in one side of his body. Although stable when he was admitted to hospital, our client later suffered multiple serious seizures and showed signs of neurological deterioration.
Despite various investigations being undertaken which showed results which were consistent with encephalitis, Aciclovir was not prescribed for three days after our client’s admission to hospital.
He sadly suffered a severe brain injury as a result of the inflammation to his brain and was subsequently diagnosed with cerebral palsy.
Our client now suffers from serious physical and learning disabilities affecting his and his family’s everyday lives.
Leigh Day has issued proceedings against the NHS Trust responsible for the hospital where our client was treated to claim for compensation which will allow our client’s high level of care, therapy and education needs to be met.