Encephalitis has been defined as inflammation of the brain parenchyma resulting in neurologic dysfunction. Incidence is approximately 12.6 per 100,000 population.1 Acute encephalitis is a medical emergency and early treatment improves the chances of disability-free survival. A high index of suspicion is necessary to diagnose and manage these patients promptly.

Encephalitis results from infectious (most commonly viral) or autoimmune causes. Autoimmune encephalitis is thought to be as common as infections in industrialized countries. However, in about 50% of cases,2 the aetiology remains elusive.

Patients are often unwell and can progress to develop coma and cardiorespiratory compromise. Intensive care is necessary in a significant proportion of patients, and an organized approach is required. With this article, we will outline steps in managing adult patients with encephalitis, which can then be applied to individual practice.