Treatments and drugs

By Mayo Clinic Staff

Treatment for mild cases, which may be mistaken as the flu, mainly consists of:

  • Bed rest
  • Plenty of fluids
  • Anti-inflammatory drugs— such as acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve, others) — to relieve headaches and fever.

Antiviral drugs

Cases of encephalitis due to certain viruses usually require intravenous antiviral treatments. Antiviral drugs commonly used to treat encephalitis include:

  • Acyclovir (Zovirax)
  • Ganciclovir (Cytovene)
  • Foscarnet (Foscavir)

Some viruses, such as insect-borne viruses, don't respond to these treatments. However, because the specific virus may not be identified immediately or at all, treatment with acyclovir is often begun immediately. This drug can be effective against the herpes simplex virus, which can result in significant complications, such as encephalitis, or death when not treated promptly.

Side effects of antiviral drugs may include nausea, vomiting, diarrhea, and muscle or joint soreness or pain. Rare serious problems may include abnormalities in kidney or liver function or suppression of bone marrow activity. Appropriate tests are used to monitor for serious adverse effects.

Supportive care

Additional supportive care also is needed in the hospital for people with severe encephalitis. The care may include:

  • Breathing assistance, as well as careful monitoring of breathing and heart function
  • Intravenous fluids to ensure proper hydration and appropriate levels of essential minerals
  • Anti-inflammatory drugs, such as corticosteroids, to help reduce swelling and pressure within the skull
  • Anticonvulsant medications, such as phenytoin (Dilantin), to stop or prevent seizures.

Follow-up therapy

After the initial illness, it may be necessary to receive additional therapy depending on the type and severity of complications. This therapy may include:

  • Physical therapy to improve strength, flexibility, balance, motor coordination and mobility
  • Occupational therapy to develop everyday skills and to use adaptive products that help with everyday activities
  • Speech therapy to relearn muscle control and coordination to produce speech
  • Psychotherapy to learn coping strategies and new behavioral skills to improve mood disorders or address personality changes — with medication management if necessary
May 15, 2014