Recognition
- Sudden onset of high fever and severe headache
- Confusion, memory loss, irritability, personality changes
- Double vision, slurred speech, hearing impairment (cranial nerve or brainstem involvement)
- Seizures, tics, partial or full paralysis
- Tachycardia and elevated body temperature
- Drowsiness, stupor, or coma in severe cases
- Common causes: Primary viral (enteroviruses, arboviruses including West Nile), secondary to herpes simplex, mumps, measles, or chickenpox. Non-viral causes include bacteria, fungi, protozoa (toxoplasmosis), and environmental toxins (lead)
- Most vulnerable: Infants, elderly, and immunosuppressed individuals (HIV/AIDS)
MT Relevance
- Acute encephalitis systemically contraindicates massage — active brain infection with serious complications
- Post-recovery without residual damage: Standard massage with no special modifications
- Post-recovery with residual deficits: Stroke-like deficits, seizure disorders, or paralysis may persist and require significant positioning and technique modifications (treat as per the specific residual condition)
Required Actions
- High fever + confusion + slurred speech + motor control loss = immediate medical emergency — call 911
- Do not treat during active infection
- Monitor for residual deficits in post-recovery clients. Rabies encephalitis is nearly 100% fatal — the rarest but most dangerous form
Key Takeaways
- Acute encephalitis systemically contraindicates massage. It is an active brain infection with serious complications.
- High fever combined with confusion, slurred speech, and motor control loss requires immediate medical attention.
- Post-recovery clients with no lasting damage receive standard massage. Those with residual deficits need significant modifications.
- Encephalitis can leave permanent sequelae including stroke, seizure disorders, and paralysis.
- The condition frequently co-occurs with meningitis or myelitis.