What is a significant feature of encephalitis compared to viral meningitis?

A significant feature of encephalitis compared to viral meningitis is the presence of altered mental status. Encephalitis involves inflammation of the brain itself and typically results in more pronounced neurological symptoms, including confusion, altered consciousness, seizures, and focal neurological deficits. While viral meningitis can also cause some level of change in mental status, it tends to be less severe, and patients with meningitis often present with classic symptoms such as fever, headache, and neck stiffness but usually retain a clearer level of consciousness.

The difference lies in the underlying pathophysiology: encephalitis affects the brain parenchyma, leading to more severe manifestations of neurological dysfunction. In contrast, viral meningitis primarily affects the meninges (the protective membranes covering the brain and spinal cord) and is characterized by symptoms stemming from meningeal irritation rather than direct brain tissue involvement. Therefore, altered mental status serves as a more defining feature in patients with encephalitis and reflects the severity of central nervous system involvement.