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Encephalitis and myelitis are diffuse inflammatory processes leading to neuronal death and brain swelling

Diffuse inflammation of the brain (encephalitis)} and cord (myelitis) is caused by viral, rickettsial and certain bacterial organisms (mainly Listeria, Treponema, and Borrelia).
The main viral organisms responsible for this pattern of infection are herpes simplex, polio and rabies. Clinically, diffuse inflammation causes neurological dysfunction manifest by myelopathy (motor and sensory signs) or encephalopathy (confusion and reduced level of consciousness).

Macroscopically, there is hyperaemia of the meninges, petechial haemorrhages in the brain, and brain swelling due to oedema. In some types, e.g. encephalitis due to Herpes simplex, there is extensive brain necrosis. The results of encephalitis or myelitis are death of neurons, cuffing of cerebral blood vessels by lymphoid cells, and astrocytic gliosis.

Depending on the cause, viral cellular inclusion bodies may be seen. For example, cytoplasmic Negri bodies are seen in rabies, and nuclear viral inclusion bodies are seen in herpes encephalitis.
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