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Meningitis and Encephalitis
A guide for patients and carers
Other problems that can be confused with meningitis and encaphilitis
Other infections
Any viral or bacterial infection (e.g. urinary tract infection, chest infection) cancause drowsiness and vomiting in children. There may also be mild neck stiffness because of painful neck glands. In very elderly people, infection in any site can cause confusion and fever (as can some medications e.g. painkillers).
Non-infective causes of meningitis
Cancer cells can spread to the meninges and cause inflammation. This can result in headaches, photophobia (discomfort in bright light), neck stiffness, confusion and sometimes weakness in the arms or legs. This does not cause fever, and usually there is a past history of cancer and signs of advancing cancer in other areas. Spinal fluid analysis may show up malignant cells.
Sub-arachnoid haemorrhage
Bleeding into the CSF spaces (sub-arachnoid haemorrhage) causes an inflammatory reaction on the meninges which in turn leads to headaches, nausea, vomiting, photophobia and severe neck stiffness, which could be confused with meningitis. In addition, there may be drowsiness and problems with weakness on one side of the body or language difficulty, which might suggest encephalitis or a cerebral abscess. The start of these symptoms in the case of a sub-arachnoid haemorrhage is usually immediate or takes a few seconds, rather than hours or days, as in the case of encephalitis or meningitis. Fever is unusual. A CT brain scan will almost always show blood in the CSF spaces, and in the small number of cases where this is not seen, lumbar puncture will show the presence of blood in the CSF rather than pus.
Brain tumours or blood clots
Brain tumours and blood clots in the skull between the meninges (sub-dural haematoma) can cause gradual confusion, headache and weakness down one side of the body or language problems. These symptoms will develop over several hours or days and are similar to those which occur in encephalitis or cerebral abscess, but there is usually no fever and neck stiffness.
Migraine
Migraine can cause headaches, nausea, vomiting, photophobia and a resistance to being moved because of worsening headache. Fever is not a sign of migraine. Usually the past history of migraine, the description of the headache, which is often one-sided, and the lack of neck stiffness is sufficient to help distinguish this from meningitis. However, if there is any doubt then lumbar puncture is usually carried out.
Any viral or bacterial infection (e.g. urinary tract infection, chest infection) cancause drowsiness and vomiting in children. There may also be mild neck stiffness because of painful neck glands. In very elderly people, infection in any site can cause confusion and fever (as can some medications e.g. painkillers).
Non-infective causes of meningitis
Cancer cells can spread to the meninges and cause inflammation. This can result in headaches, photophobia (discomfort in bright light), neck stiffness, confusion and sometimes weakness in the arms or legs. This does not cause fever, and usually there is a past history of cancer and signs of advancing cancer in other areas. Spinal fluid analysis may show up malignant cells.
Sub-arachnoid haemorrhage
Bleeding into the CSF spaces (sub-arachnoid haemorrhage) causes an inflammatory reaction on the meninges which in turn leads to headaches, nausea, vomiting, photophobia and severe neck stiffness, which could be confused with meningitis. In addition, there may be drowsiness and problems with weakness on one side of the body or language difficulty, which might suggest encephalitis or a cerebral abscess. The start of these symptoms in the case of a sub-arachnoid haemorrhage is usually immediate or takes a few seconds, rather than hours or days, as in the case of encephalitis or meningitis. Fever is unusual. A CT brain scan will almost always show blood in the CSF spaces, and in the small number of cases where this is not seen, lumbar puncture will show the presence of blood in the CSF rather than pus.
Brain tumours or blood clots
Brain tumours and blood clots in the skull between the meninges (sub-dural haematoma) can cause gradual confusion, headache and weakness down one side of the body or language problems. These symptoms will develop over several hours or days and are similar to those which occur in encephalitis or cerebral abscess, but there is usually no fever and neck stiffness.
Migraine
Migraine can cause headaches, nausea, vomiting, photophobia and a resistance to being moved because of worsening headache. Fever is not a sign of migraine. Usually the past history of migraine, the description of the headache, which is often one-sided, and the lack of neck stiffness is sufficient to help distinguish this from meningitis. However, if there is any doubt then lumbar puncture is usually carried out.
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Contents
- Introduction
- What is meningitis?
- What is encephalitis?
- What are the symptoms?
- Tests used to diagnose meningitis and encaphilitis
- Other problems that can be confused with meningitis and encaphilitis
- Treatment of meningitis
- Treatment of encaphalitis
- How well do people respond to treatment?
- Other help available to patients and carers
- Getting back to normal
- Things to be avoided
- Some do's and don'ts
- Summary
- Other Organisations that may be able to help
