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Loss of appetite
Have a fever
Weak
Problems remembering
Have a headache
Brain fog
Change in personality
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What is Encephalitis / Encephalopathy?
Encephalitis and encephalopathy are brain conditions that can result in permanent damage. Encephalitis refers to brain inflammation, while encephalopathy is a broad term for any brain disease or disorder. Several causes can lead to these conditions, including infections, trauma, metabolic problems, drugs, and lack of oxygen to the brain.
Typical Symptoms of Encephalitis / Encephalopathy
- Seizure
- History of HIV or AIDS
- Smile is not symmetrical
- Difficulty speaking, performing tasks, or recognizing things
- Weakness or paralysis on one side of your body
- Pain at the back of the head
- Unable to execute simple commands such as 'squeeze my hand and then let it go'
- Personality change
Diagnostic Questions for Encephalitis / Encephalopathy
Your doctor may ask these questions to check for this disease:
- Have you experienced any seizures?
- Have you ever been diagnosed with HIV or AIDS?
- Is it hard to raise one corner of your mouth when you smile?
- Have you been experiencing difficulty speaking, performing tasks, or recognizing things?
- Do you have weakness or paralysis on one side of your body?
Treatment of Encephalitis / Encephalopathy
Treatment depends on the cause of the brain condition. Medications to reduce inflammation, eliminate infection, and slow brain damage progression may be used, and in some cases, surgery may be required. Anti-seizure medication is prescribed for seizures. Supportive treatment with fluids injected into the vein is needed to keep the patient stable.
Reviewed By:
Maxwell J. Nanes, DO (Emergency Medicine)
Dr Nanes received a doctorate from the Chicago College of Osteopathic Medicine and went on to complete a residency in emergency medicine at the Medical College of Wisconsin. There he trained at Froedtert Hospital and Children's Hospital of Wisconsin in the practice of adult and pediatric emergency medicine. He was a chief resident and received numerous awards for teaching excellence during his time there. | | After residency he took a job at a community hospital where he and his colleagues worked through the toughest days of the COVID-19 pandemic. |
Shohei Harase, MD (Neurology)
Dr. Harase spent his junior and senior high school years in Finland and the U.S. After graduating from the University of Washington (Bachelor of Science, Molecular and Cellular Biology), he worked for Apple Japan Inc. before entering the University of the Ryukyus School of Medicine. He completed his residency at Okinawa Prefectural Chubu Hospital, where he received the Best Resident Award in 2016 and 2017. In 2021, he joined the Department of Cerebrovascular Medicine at the National Cerebral and Cardiovascular Center, specializing in hyperacute stroke.
Content updated on Feb 13, 2025
Following the Medical Content Editorial Policy
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- My body is jerking
- Twitching
- Fever seizures (with fever of >100.4°F / 38°C)
- Antisocial behavior and language difficulty
- Seizures without fever
- The first seizure
- Repetitive seizures
- Seizure with fainting
- Can't say what I want to say
- Seizures when I wake up
- I have a seizure that is not symmetric
- Recently had a seizure
- I am currently having convulsions lasting less than 5 minutes
- Experienced a seizure lasting longer than usual but lasting less than 10 minutes
- Speech is difficult and requires conscious effort
See full list
Symptoms Related to Encephalitis / Encephalopathy
Diseases Related to Encephalitis / Encephalopathy
FAQs
Q.
Are brain-eating amoeba infections rare in the US?
A.
Yes, brain-eating amoeba infections are very rare in the US, with only a few cases reported each year.
References:
Mukhtar F, & Wazir MS. (2015). NAEGLARIA FOWLERI: THE BRAIN EATING AMOEBA OR .... Journal of Ayub Medical College, Abbottabad :, JAMC.., 26721056.
https://pubmed.ncbi.nlm.nih.gov/26721056/
Pugh JJ, & Levy RA. (2016). Naegleria fowleri: Diagnosis, Pathophysiology of Brain .... ACS chemical neuroscience, 27525348.
https://pubmed.ncbi.nlm.nih.gov/27525348/
Yoder JS, Eddy BA, Visvesvara GS, Capewell L, & Beach MJ. (2010). The epidemiology of primary amoebic .... Epidemiology and infection, 19845995.
Q.
Can you get brain-eating amoeba from drinking water?
A.
You can't get brain-eating amoeba from drinking water, but it can be dangerous if it goes up your nose.
References:
Kim JH, Sohn HJ, Shin HJ, Walz SE, & Jung SY. (2024). Understanding the pathogenicity of Naegleria fowleri in .... Parasites, hosts and diseases, 39622651.
https://pubmed.ncbi.nlm.nih.gov/39622651
Centers for Disease Control and Prevention (CDC). (2013). primary amebic meningoencephalitis associated with ritual .... MMWR. Morbidity and mortality weekly report, 24226628.
https://pubmed.ncbi.nlm.nih.gov/24226628/
Daft BM, Visvesvara GS, Read DH, Kinde H, Uzal FA, & Manzer MD. (2005). Seasonal meningoencephalitis in Holstein cattle caused by .... Journal of veterinary diagnostic investigation : official publication of the American Association of Veterinary Laboratory Diagnosticians, Inc, 16475525.
Q.
Can you survive a brain-eating amoeba infection?
A.
Surviving a brain-eating amoeba infection is very rare, but there have been a few cases of survival with early diagnosis and treatment.
References:
Heggie TW, & Küpper T. (2017). Surviving Naegleria fowleri infections: A successful case .... Travel medicine and infectious disease, 28013053.
https://pubmed.ncbi.nlm.nih.gov/28013053/
Pugh JJ, & Levy RA. (2016). Naegleria fowleri: Diagnosis, Pathophysiology of Brain .... ACS chemical neuroscience, 27525348.
https://pubmed.ncbi.nlm.nih.gov/27525348/
Moseman AP, Chen C-w, Liang X, Liao D, Kuraoka M, & Moseman EA. (2024). Therapeutic glycan-specific antibody binding mediates .... Infection and immunity, 39235225.
Q.
How do you get infected with brain-eating amoeba?
A.
You can get infected with brain-eating amoeba by swimming in warm freshwater lakes or rivers where the amoeba lives. It enters the body through the nose and travels to the brain.
References:
Saleem T, Jamal SB, Alzahrani B, Basheer A, Wajid Abbasi S, Ali M, et al. (2023). In-silico drug design for the novel Karachi-NF001 strain .... Frontiers in molecular biosciences, 36845543.
https://pubmed.ncbi.nlm.nih.gov/36845543/
Lawande RV, Macfarlane JT, Weir WR, & Awunor-Renner C. (1980). A case of primary amebic meningoencephalitis in .... The American journal of tropical medicine and hygiene, 7352624.
https://pubmed.ncbi.nlm.nih.gov/7352624/
Köseoğlu AE, Özgül F, Işıksal EN, Şeflekçi Y, Tülümen D, Özgültekin B, et al. (2024). In silico discovery of diagnostic/vaccine candidate .... Gene, 38253295.
Q.
How quickly does PAM infection progress?
A.
PAM infection, caused by Naegleria fowleri, progresses very quickly, often within a few days of exposure.
References:
Phung NTN, Pham HT, Tran TT, Dinh VH, Tran NM, Tran NAN, et al. (2025). Naegleria fowleri: Portrait of a Cerebral Killer. Diagnostics (Basel, Switzerland), 39795618.
https://pubmed.ncbi.nlm.nih.gov/39795618/
Wang Q, Li J, Ji J, Yang L, Chen L, Zhou R, et al. (2018). A case of Naegleria fowleri related primary amoebic .... BMC infectious diseases, 30055569.
https://pubmed.ncbi.nlm.nih.gov/30055569/
Rodríguez-Mera IB, Rojas-Hernández S, Barrón-Graciano KA, & Carrasco-Yépez MM. (2024). Analysis of virulence factors in extracellular vesicles .... Parasitology research, 39432113.
Q.
How to prevent brain-eating amoeba infection?
A.
To prevent brain-eating amoeba infections, avoid swimming in warm freshwater and use properly treated water for activities like swimming and splashing.
References:
Dulski TM, Montgomery F, Ramos JM, Rosenbaum ER, Boyanton BL Jr, Cox CM, et al. (2025). Fatal Case of Splash Pad-Associated Naegleria fowleri .... MMWR. Morbidity and mortality weekly report, 40146665.
https://pubmed.ncbi.nlm.nih.gov/40146665/
Alanazi A, Younas S, Ejaz H, Alruwaili M, Alruwaili Y, Mazhari BBZ, et al. (2025). Advancing the understanding of Naegleria fowleri: Global .... Journal of infection and public health, 39913985.
https://pubmed.ncbi.nlm.nih.gov/39913985/
Sohn HJ, Park AY, Lee JH, Yun KH, Song KJ, Kim JH, & Shin HJ. (2024). Amoebicidal effect of chlorine dioxide gas against .... Parasitology research, 38652173.
Q.
How to protect yourself from Naegleria fowleri when swimming?
A.
To protect yourself from Naegleria fowleri when swimming, avoid warm freshwater and prevent water from entering your nose.
References:
Alanazi A, Younas S, Ejaz H, Alruwaili M, Alruwaili Y, Mazhari BBZ, et al. (2025). Advancing the understanding of Naegleria fowleri: Global .... Journal of infection and public health, 39913985.
https://pubmed.ncbi.nlm.nih.gov/39913985/
Yoder JS, Blackburn BG, Craun GF, Hill V, Levy DA, Chen N, et al. (2004). Surveillance for waterborne-disease outbreaks associated .... Morbidity and mortality weekly report. Surveillance summaries (Washington, D.C. : 2002), 15499306.
https://pubmed.ncbi.nlm.nih.gov/15499306/
Daft BM, Visvesvara GS, Read DH, Kinde H, Uzal FA, & Manzer MD. (2005). Seasonal meningoencephalitis in Holstein cattle caused by .... Journal of veterinary diagnostic investigation : official publication of the American Association of Veterinary Laboratory Diagnosticians, Inc, 16475525.
Q.
How to safely rinse sinuses to avoid amoeba?
A.
To rinse your sinuses safely and avoid amoeba infections, use sterile or distilled water and keep your nasal rinse equipment clean.
References:
Haston JC, Serra C, Imada E, Martin E, Ali IKM, & Cope JR. (2024). Acanthamoeba Infection and Nasal Rinsing, United States .... Emerging infectious diseases, 38526242.
https://pubmed.ncbi.nlm.nih.gov/38526242/
Alanazi A, Younas S, Ejaz H, Alruwaili M, Alruwaili Y, Mazhari BBZ, et al. (2025). Advancing the understanding of Naegleria fowleri: Global .... Journal of infection and public health, 39913985.
https://pubmed.ncbi.nlm.nih.gov/39913985/
Brook I. (2002). Bacterial contamination of saline nasal spray/drop solution .... American journal of infection control, 12032501.
Q.
Is brain-eating amoeba contagious?
A.
The brain-eating amoeba, known as Naegleria fowleri, is not contagious and cannot be spread from person to person.
References:
Ong TY, Khan NA, & Siddiqui R. (2017). Predilection Sites in the Brain and Disease Outcome - PMC. Journal of Clinical Microbiology, 5483900.
https://pmc.ncbi.nlm.nih.gov/articles/PMC5483900/
Archibald LK, & Quisling RG. (2013). Central Nervous System Infections - PMC. Textbook of Neurointensive Care, 7122753.
https://pmc.ncbi.nlm.nih.gov/articles/PMC7122753/
Mohd Hussain RH, Abdul Ghani MK, Khan NA, Siddiqui R, Aazmi S, Halim H, & Anuar TS. (2022). In Vitro Cytopathogenic Activities of Acanthamoeba T3 and .... Pathogens, 9782662.
Q.
Is brain-eating amoeba fatal?
A.
Yes, the brain-eating amoeba, Naegleria fowleri, is often fatal when it causes an infection.
References:
Jahangeer M, Mahmood Z, Munir N, Waraich UE, Tahir IM, Akram M, et al. (2020). Naegleria fowleri: Sources of infection, pathophysiology, .... Clinical and experimental pharmacology & physiology, 31612525.
https://pubmed.ncbi.nlm.nih.gov/31612525/
Güémez A, & García E. (2021). Primary Amoebic Meningoencephalitis by Naegleria fowleri. Biomolecules, 34572533.
https://pubmed.ncbi.nlm.nih.gov/34572533/
Baig AM. (2016). Primary Amoebic Meningoencephalitis: Neurochemotaxis .... ACS chemical neuroscience, 27447543.
Q.
Is it safe to swim in warm freshwater lakes?
A.
Swimming in warm freshwater lakes can be risky due to the presence of harmful amoebas that can cause serious illness.
References:
Yasir M, & Herekar FF. (2024). Unexpected trends of amoebic encephalitis in Pakistan. Tropical doctor, 38130144.
https://pubmed.ncbi.nlm.nih.gov/38130144/
Köseoğlu AE, Özgül F, Işıksal EN, Şeflekçi Y, Tülümen D, Özgültekin B, et al. (2024). In silico discovery of diagnostic/vaccine candidate .... Gene, 38253295.
https://pubmed.ncbi.nlm.nih.gov/38253295/
Cope JR, Murphy J, Kahler A, Gorbett DG, Ali I, Taylor B, et al. (2018). Case Report and Environmental Investigation. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 29401275.
Q.
What are the early signs of brain-eating amoeba?
A.
The early signs of a brain-eating amoeba infection include headache, fever, nausea, and vomiting. These symptoms can start within a few days of infection.
References:
Ahmad Zamzuri M'I, Abd Majid FN, Mihat M, Ibrahim SS, Ismail M, Abd Aziz S, et al. (2023). Systematic Review of Brain-Eating Amoeba: A Decade .... International journal of environmental research and public health, 36833715.
https://pubmed.ncbi.nlm.nih.gov/36833715/
Borkens Y. (2024). The Pathology of the Brain Eating Amoeba Naegleria fowleri. Indian journal of microbiology, 39282207.
https://pubmed.ncbi.nlm.nih.gov/39282207/
Sugita Y, Fujii T, Hayashi I, Aoki T, Yokoyama T, Morimatsu M, et al. (1999). Primary amebic meningoencephalitis due to Naegleria .... Pathology international, 10417693.
Q.
What are the specific symptoms of PAM infection?
A.
Primary Amebic Meningoencephalitis (PAM) symptoms include headache, fever, nausea, vomiting, and stiff neck, often progressing to confusion and seizures.
References:
Hoseininia S, Salimi M, Salmani A, Jannati R, & Negaresh M. (2024). Alveolar Microlithiasis with Mild Clinical Symptoms But .... Clinical medicine insights. Case reports, 38450045.
https://pubmed.ncbi.nlm.nih.gov/38450045
Chen M, Ruan W, Zhang L, Hu B, & Yang X. (2019). Primary Amebic Meningoencephalitis: A Case Report. The Korean journal of parasitology, 31284352.
https://pubmed.ncbi.nlm.nih.gov/31284352/
Jindal A, Rahulan V, Balasubramani G, Dutta P, & Attawar S. (2019). A rare disease treated with lung transplantation, first case .... Lung India : official organ of Indian Chest Society, 31670305.
Q.
What are the symptoms of brain-eating amoeba infection?
A.
Brain-eating amoeba infection can cause symptoms like headache, fever, nausea, vomiting, and confusion. It progresses quickly and is very serious.
References:
Ahmad Zamzuri M'I, Abd Majid FN, Mihat M, Ibrahim SS, Ismail M, Abd Aziz S, et al. (2023). Systematic Review of Brain-Eating Amoeba: A Decade .... International journal of environmental research and public health, 36833715.
https://pubmed.ncbi.nlm.nih.gov/36833715/
Sugita Y, Fujii T, Hayashi I, Aoki T, Yokoyama T, Morimatsu M, et al. (1999). Primary amebic meningoencephalitis due to Naegleria .... Pathology international, 10417693.
https://pubmed.ncbi.nlm.nih.gov/10417693/
López-Corella E, De León B, & de Jonckheere JF. (1989). [Primary amebic meningoencephalitis caused by Naegleria .... Boletin medico del Hospital Infantil de Mexico, 2604877.
Q.
What happens if water goes up your nose while swimming?
A.
If water goes up your nose while swimming, it can sometimes be risky due to germs like Naegleria fowleri, which can cause serious illness. However, such infections are rare, and most of the time, water in the nose is harmless.
References:
Jahangeer M, Mahmood Z, Munir N, Waraich UE, Tahir IM, Akram M, et al. (2020). Naegleria fowleri: Sources of infection, pathophysiology, .... Clinical and experimental pharmacology & physiology, 31612525.
https://pubmed.ncbi.nlm.nih.gov/31612525/
Cope JR, Murphy J, Kahler A, Gorbett DG, Ali I, Taylor B, et al. (2018). Case Report and Environmental Investigation. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 29401275.
https://pubmed.ncbi.nlm.nih.gov/29401275/
Brook I. (2002). Bacterial contamination of saline nasal spray/drop solution .... American journal of infection control, 12032501.
Q.
What is Primary Amebic Meningoencephalitis (PAM)?
A.
Primary Amebic Meningoencephalitis (PAM) is a rare and severe brain infection caused by the amoeba Naegleria fowleri, usually found in warm freshwater. It often leads to rapid and severe brain inflammation, and unfortunately, it is usually fatal.
References:
Hall AD, Kumar JE, Golba CE, Luckett KM, & Bryant WK. (2024). a review of Naegleria fowleri and analysis of successfully .... Parasitology research, 38182931.
https://pubmed.ncbi.nlm.nih.gov/38182931/
Hannisch W, & Hallagan LF. (1997). Primary amebic meningoencephalitis: a review of the .... Wilderness & environmental medicine, 11990164.
https://pubmed.ncbi.nlm.nih.gov/11990164/
Cope JR, & Ali IK. (2016). Primary Amebic Meningoencephalitis: What Have We .... Current infectious disease reports, 27614893.
Q.
What is the brain-eating amoeba?
A.
The brain-eating amoeba, known as Naegleria fowleri, is a tiny organism found in warm freshwater that can cause a serious brain infection.
References:
Jahangeer M, Mahmood Z, Munir N, Waraich UE, Tahir IM, Akram M, et al. (2020). Naegleria fowleri: Sources of infection, pathophysiology, .... Clinical and experimental pharmacology & physiology, 31612525.
https://pubmed.ncbi.nlm.nih.gov/31612525/
Alanazi A, Younas S, Ejaz H, Alruwaili M, Alruwaili Y, Mazhari BBZ, et al. (2025). Advancing the understanding of Naegleria fowleri: Global .... Journal of infection and public health, 39913985.
https://pubmed.ncbi.nlm.nih.gov/39913985/
Güémez A, & García E. (2021). Primary Amoebic Meningoencephalitis by Naegleria fowleri. Biomolecules, 34572533.
Q.
What kind of water does Naegleria fowleri thrive in?
A.
Naegleria fowleri thrives in warm freshwater like lakes and hot springs, especially during hot weather.
References:
Cope JR, Ratard RC, Hill VR, Sokol T, Causey JJ, Yoder JS, et al. (2015). The first association of a primary amebic .... Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 25595746.
https://pubmed.ncbi.nlm.nih.gov/25595746/
Stahl LM, & Olson JB. (2023). Investigating the interactive effects of temperature, pH, and .... The Journal of eukaryotic microbiology, 36709487.
https://pubmed.ncbi.nlm.nih.gov/36709487/
Heggie TW. (2010). Naegleria fowleri infections in recreational waters. Travel medicine and infectious disease, 20970721.
Q.
Where is Naegleria fowleri commonly found?
A.
Naegleria fowleri is commonly found in warm freshwater, such as lakes and hot springs, where it can cause infections if it enters the nose.
References:
Heggie TW, & Küpper T. (2017). Surviving Naegleria fowleri infections: A successful case .... Travel medicine and infectious disease, 28013053.
https://pubmed.ncbi.nlm.nih.gov/28013053/
Aurongzeb M, Fatima SZ, Hussain SI, Rashid Y, Aziz T, Alhomrani M, et al. (2025). Detection and identification of Naegleria species along .... BMC medical genomics, 39780139.
https://pubmed.ncbi.nlm.nih.gov/39780139/
Heggie TW. (2010). Naegleria fowleri infections in recreational waters. Travel medicine and infectious disease, 20970721.
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https://pubmed.ncbi.nlm.nih.gov/37490360/Ellul M, Solomon T. Acute encephalitis - diagnosis and management. Clin Med (Lond). 2018 Mar;18(2):155-159. doi: 10.7861/clinmedicine.18-2-155. PMID: 29626021; PMCID: PMC6303463.
https://pubmed.ncbi.nlm.nih.gov/29626021/Erkkinen MG, Berkowitz AL. A Clinical Approach to Diagnosing Encephalopathy. Am J Med. 2019 Oct;132(10):1142-1147. doi: 10.1016/j.amjmed.2019.07.001. Epub 2019 Jul 19. PMID: 31330129.
https://pubmed.ncbi.nlm.nih.gov/31330129/