The sores associated with shingles don't break out on the brain, but shingles can affect nerves that lead to brain inflammation, which is known as encephalitis. The symptoms of encephalitis include seizures, confusion, motor or sensory problems, and flu-like signs, and medical treatment is necessary, notes Mayo Clinic.
To confirm that the virus active in shingles has attacked the nerves that cause encephalitis, a doctor is likely to order multiple tests, including a CT or MRI scan to get an image of the brain and determine whether swelling has taken place. A lumbar puncture, or spinal tap, gives a doctor access to the spinal fluid. Elevated levels of protein and white blood cells in this fluid as well as the herpes zoster virus, which leads to shingles, indicate the presence of encephalitis. Blood tests also show the kind of virus causing the brain swelling, notes WebMD.
While encephalitis is rarely life-threatening, severe cases happen often enough to make hospital treatment necessary. Antiviral medicines such as acyclovir help alleviate the symptoms, and depending on other symptoms, individuals may also receive medicine to reduce fever or pain and prevent seizures. Severe cases require placement on a ventilator to help with breathing. Recovery time after leaving the hospital can last several months or longer, and some people require physical therapy or occupational therapy to deal with muscle weakness or memory or speech loss, according to WebMD.