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Neurology and Neurosurgery

Encephalitis Center

Encephalitis Research

Researchers at the Johns Hopkins Encephalitis Center are dedicated to advancing the science behind encephalitis causes, diagnosis and treatment to help improve patient care.

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Pathogen Discovery

Over 60% of the time, the specific cause of encephalitis cannot be determined. We are working with several groups to identify novel pathogens that cause encephalitis. Identifying these organisms is the first step in developing effective treatments.

To identify novel pathogens that cause encephalitis, our team is using cutting-edge genetic techniques in collaboration with several groups of investigators. We anticipate that these approaches, which include newly developed modifications of the polymerase chain reaction (PCR) technique, as well as whole genome sequencing approaches, will enable us to discover new viruses and bacteria that cause encephalitis.

Immunology of Encephalitis

Encephalitis can be caused by a wide variety of conditions that fall into various categories, including infectious, autoimmune and neoplastic conditions. By characterizing the immune response in the cerebrospinal fluid (CSF), we hope to be able to categorize the type of encephalitis that a patient is experiencing, leading to a more effective treatment.

Biorepository

We are continuing to grow and use our biorepository of CSF and serum from patients with neurological infections and neuroinflammatory disorders, including encephalitis. As new data on encephalitis is reported, we can confirm and extend these findings through our repository.

Ketogenic Diet Therapies for Patients With Encephalitis and RSE/SRSE

Our research team works closely with the Epilepsy Diet Center at The Johns Hopkins Hospital. We are studying the effect of ketogenic diet on patients with encephalitis who have uncontrollable seizures or status epilepticus as inpatients, or those who continue having seizures after the acute phase.

Diagnostic Tools, Treatments and Outcomes

The diagnostic tests and treatment options for encephalitis are very limited. Our team is working to find the best treatments for this condition while studying brain imaging and blood tests that might help with identification of encephalitis. And we use advanced neuro-critical care diagnostic and therapeutic modalities to limit brain damage in the acute setting. Seizures, for example, are a major cause of morbidity among encephalitis patients in the acute setting. We are using continuous electrical monitoring of patients’ brains and aggressive anti-epileptic strategies to limit seizure activity. Additional approaches include cutting-edge medical and surgical techniques to monitor and treat the brain swelling that accompanies encephalitis, as well as comprehensive ventilator and nutritional support for such patients.

Prodromal and Sequelae Post-Encephalitis

Sequelae post-encephalitis, such as seizures, behavioral changes, headaches, fatigue and cognitive problems, have been described but have not been characterized in a systematic manner. We are trying to measure the severity and impact of these sequelae. Likewise, we are creating strategies to help patients deal with these symptoms in their daily lives.

Biomarkers of Autoimmune Encephalitis: FDG-PET Scan

Our team recently discovered that 85% of patients with autoimmune encephalitis had abnormal fluorodeoxyglucose (FDG)-positron emission tomography (PET) scans, suggesting that this could be a sensitive test for detecting autoimmune encephalitis even when brain MRI and other tests appear normal. We are collaborating with the Johns Hopkins Department of Radiology to explore brain FDG-PET as a biomarker for diagnosis and staging of autoimmune encephalitis.