It's Not Just the Flu, 6 Signs of Brain Inflammation |
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Encephalitis is life-threatening brain inflammation, and it's often missed or misdiagnosed.
Delayed or missed diagnosis of encephalitis can cause permanent injury to the brain or death.
By Praveen Prathapan and Ava Easton, Ph.D., MBE
What if the worst day of your life started with something utterly ordinary? A headache. A fever. A strange mood. Maybe someone you know seemed “not quite themselves.” A little forgetful. Irritable. Confused. You might tell them to rest, drink fluids, and sleep it off. But what if those early signs weren’t a virus you could shake off in a week?
Every 20 seconds, someone, somewhere in the world, is diagnosed with encephalitis: inflammation of the brain. It can be caused by infections or by the immune system going wrong and attacking the brain in error. Unfortunately, when diagnosis is delayed, the consequences can be devastating for people, including death and injury to the brain that can include cognitive, emotional, social, and physical changes that can be life-changing. Yet, most people have never heard of encephalitis. And, many frontline clinicians don’t feel confident in recognising it early.
In 2024, we surveyed 614 emergency medical professionals across India, the Philippines, the US, the UK, Germany, and Australia. Only a third strongly agreed that their training had given them confidence to recognise encephalitis. Two-thirds of emergency professionals surveyed did not feel fully confident identifying a potentially fatal brain condition early. This is not about blame. It simply reflects reality: encephalitis mimics other illnesses. It can look psychiatric, or like other infections, or like a stroke, among many other things.
When the Brain Is on Fire
Encephalitis is not rare or exotic, nor is it confined to any one age group, gender, or country. Early symptoms can be vague and sometimes easily dismissed: flu-like, headache, memory problems, drowsiness, unusual behaviour. Families often say the same thing at the bedside or afterwards: “We knew something wasn’t right, they just weren't acting like themselves.”
What if we made encephalitis easier to spot?
Flames is a public awareness initiative designed to support earlier recognition of possible encephalitis:
F – Flu-like symptoms
L – Loss of consciousness
E – Emotional or behavioural changes
These are the most commonly reported features across infectious and autoimmune encephalitis. Individually, each symptom might not alarm you. Together—or rapidly evolving—they should. The message is simple: Think brain in Flames. Think encephalitis.
Awareness Matters More Than You Think
The World Health Organization’s 2025 Technical Brief on Encephalitis explicitly called for improved early clinical recognition through public and professional education. Flames is a response to that call. Awareness isn’t a luxury. It accelerates diagnosis and treatment. Autoimmune encephalitis, in particular, can present with:
Autoimmune patients are sometimes first admitted to psychiatric services. Without awareness, these presentations can be misinterpreted as primary psychiatric disorders with serious consequences for patients and families. Early recognition means rapid treatment and reduced chances of death and disability. For others, delay potentially means death or life-changing disabilities. The difference often hinges on one question asked early enough: “Could this be encephalitis?”
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See Encephalitis International.