Chart — Neurology
Meningitis vs Encephalitis Chart
Same neighborhood, different target. Meningitis inflames the coverings (meningeal signs dominate); encephalitis inflames the brain itself (altered mentation and deficits dominate, classically HSV → acyclovir).
Educational use only. Both can be life-threatening and provider-directed emergencies. This chart is an educational comparison aid. This material supports nursing education and exam review. It is not medical advice and is not a substitute for clinical judgment, institutional policy, or medical direction. Always follow facility protocols and current provider orders.
Side by Side
| Feature | Meningitis | Encephalitis |
|---|---|---|
| What's inflamed | The meninges (membranes around the brain/cord) | The brain tissue (parenchyma) itself |
| Dominant feature | Meningeal irritation: nuchal rigidity, Kernig/Brudzinski, photophobia | Altered mental status, behavior change, focal deficits, seizures |
| Mental status | May be normal early (then declines) | Altered EARLY and prominently |
| Common causes | Bacterial (N. meningitidis, S. pneumoniae) or viral | Viral — classically HSV (herpes simplex) |
| Diagnosis | LP/CSF (bacterial vs viral pattern) | LP/CSF + MRI (temporal lobe in HSV) + PCR |
| Treatment | Bacterial: prompt antibiotics + droplet precautions; viral: supportive | Empiric IV acyclovir for suspected HSV; supportive care |
| Nursing priority | Isolate + antibiotics fast; monitor ICP; quiet/dim room | Neuro/behavioral monitoring, seizure precautions, start acyclovir early |
Exam Traps
- ✦Meningitis = meninges → meningeal signs (nuchal rigidity, Kernig/Brudzinski); encephalitis = brain tissue → altered mentation/deficits.
- ✦Encephalitis is classically viral (HSV) → start empiric IV acyclovir early.
- ✦Bacterial meningitis = emergency: droplet precautions + antibiotics fast.
- ✦Both can raise ICP and cause seizures — neuro monitoring and seizure precautions for both.
Related Resources
Standards & sources
Fact-checked Jun 21, 2026This page is written to align with American Heart Association / American Stroke Association (AHA/ASA) · American Association of Neuroscience Nurses (AANN). It is an educational summary, not a citation of any single document — always verify specific doses, values, and protocols against current guidelines and your facility policy. How we source content →