How is encephalitis in children treated?

Written by Li Jiao Yan

Neonatology

Updated on September 03, 2024

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Encephalitis in children is generally treated based on the cause of the infection. It could be caused by viral infections, bacterial infections, or other pathogens. The most basic treatment is definitely to address the cause of the encephalitis. If there are other symptoms such as fever or seizures, symptomatic treatment should be administered based on these symptoms. The treatment plan should be tailored to the specific condition of the child.

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Written by Zhang Hui

Neurology

1min 25sec

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How is encephalitis diagnosed?

The diagnosis of encephalitis cannot rely solely on auxiliary examinations; it must depend on the patient's medical history, clinical manifestations, and corresponding physical examination. If a patient presents with fever, headache, nausea, vomiting, and signs of nuchal rigidity upon examination, the possibility of encephalitis should be considered. Additionally, severe cases of encephalitis may exhibit seizures, cognitive changes, and personality alterations. Auxiliary examinations mainly include three types: the first type is imaging studies, primarily brain MRI, which can clearly identify the specific areas of the brain affected and determine which brain lobe is damaged. The second important examination is an electroencephalogram (EEG), which can detect diffuse slow waves, especially a significant presence of delta waves, highly indicative of encephalitis. The third important auxiliary examination is lumbar puncture for cerebrospinal fluid analysis; an increase in white blood cells and protein in the cerebrospinal fluid also suggests inflammation within the skull. Therefore, the main auxiliary examinations for encephalitis include MRI, EEG, and lumbar puncture.

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Written by Zhang Hui

Neurology

1min 11sec

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What are the symptoms of encephalitis?

The clinical manifestations of encephalitis are complex and varied, primarily caused by infections from pathogens such as viruses and bacteria. There are numerous clinical symptoms, with fever being quite common; patients generally exhibit significant fevers, which can reach up to 38 degrees Celsius or even as high as 40 degrees Celsius. Headache is also a very common clinical manifestation of encephalitis, with some patients experiencing severe headaches accompanied by pronounced nausea and vomiting. Additionally, some patients may exhibit psychiatric symptoms, which mainly include incoherent speech, hallucinations, and failing to recognize family members. Some patients may experience cognitive impairments, such as diminished memory, and significant deficits in computational and judgment abilities. In severe cases, some patients may have epileptic seizures, characterized by convulsions of the limbs. Overall, the manifestations of encephalitis are diverse and can range from simple fever and headache to severe conditions such as psychiatric symptoms, cognitive impairments, and epilepsy.

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Written by Tang Li Li

Neurology

1min 5sec

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Can encephalitis recur?

Encephalitis comes in various types, some of which are prone to recurrence, while others are monophasic and do not recur. The most common type is viral encephalitis, particularly infections caused by the herpes simplex virus. Although recovery from viral encephalitis after antiviral treatment is possible, it may leave some sequelae, but generally does not recur. Tuberculous meningoencephalitis, however, has a higher rate of recurrence, often related to the resistance of tuberculosis bacteria and inadequate anti-tuberculosis treatment. Patients need repeated lumbar puncture tests to confirm that the cerebrospinal fluid has returned to normal levels and require long-term use of anti-tuberculosis medications. Bacterial meningitis generally does not recur. Additionally, there are some autoimmune types of encephalitis, such as autoimmune encephalitis, multiple sclerosis, and neuromyelitis optica, where recurrence is possible when involving the brain.

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Written by Zhang Hui

Neurology

1min 10sec

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What tests are done for pediatric encephalitis?

Some auxiliary examinations are very necessary for pediatric encephalitis, which help in the diagnosis and differential diagnosis of encephalitis. The main tests generally include the following: First, an electroencephalogram (EEG), which is the most commonly used examination. It is safe, non-invasive, and relatively accurate. Children with encephalitis will show light to moderate abnormalities in the EEG. Combined with the patient's history of fever and headache, it has important clinical significance for the diagnosis of encephalitis. The second important examination is cranial magnetic resonance imaging (MRI). If the encephalitis is severe, pathological changes in the cerebrospinal fluid can be seen on MRI. The third very important examination is lumbar puncture. Lumbar puncture can mainly determine the pressure of the cerebrospinal fluid, the color of the cerebrospinal fluid, and analyze the levels of white blood cells, glucose, and chloride in the cerebrospinal fluid. This is crucial for diagnosing encephalitis and excluding other types of encephalitis.

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Written by Zhang Hui

Neurology

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What tests are conducted for encephalitis?

First, it is generally necessary to conduct an EEG test. This test is very convenient and non-invasive for patients. If significant slow waves are detected, encephalitis cannot be ruled out. Secondly, an MRI of the brain should be performed. If the viral encephalitis is severe, abnormal signals can be observed in areas such as the frontal lobe, temporal lobe, and hippocampus on the MRI, which are of great diagnostic reference value. Thirdly, lumbar puncture is also very important. It allows for a direct observation of the color of the cerebrospinal fluid, to monitor the pressure of the brain fluid, and to test the cerebrospinal fluid for cell count, protein, sugar, and chloride levels. These tests are very important for the diagnosis and differential diagnosis of encephalitis.