How is a brain encephalitis puncture performed?

Written by Tang Bo

Neurology

Updated on September 08, 2024

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The encephalitis you mentioned is considered a central nervous system infection. In this case, a definitive diagnosis requires a lumbar puncture, which you referred to as a puncture. The lumbar puncture requires the patient to be in the lateral recumbent position, then the puncture is performed in the interspaces between L1-L3 or L4-L5 on the back to collect cerebrospinal fluid and conduct tests. This also allows for the examination of pathogens and pressure measurements. After the lumbar puncture, the patient needs to lie flat for six hours with a pillow removed to prevent headaches due to low cranial pressure.

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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 Zhang Hui

Neurology

54sec

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Encephalitis belongs to which department?

Encephalitis is primarily a neurological disorder and is an infectious disease of the central nervous system, mainly diagnosed and treated in neurology. There are many causes of encephalitis, with viral encephalitis being the most common. For example, herpes simplex encephalitis is a typical type seen clinically. Patients may experience fever, even with very high temperatures exceeding 40°C, headaches, nausea, and vomiting. If the condition worsens, seizures, coma, and cognitive impairment may occur. These clinical manifestations require further investigations like electroencephalography, cranial MRI, and lumbar puncture. Additionally, there is a specific type of epidemic, known as Japanese encephalitis, which falls under the category of infectious diseases due to its contagious nature.

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Written by Zhang Hui

Neurology

1min 12sec

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How to check for encephalitis?

To check for encephalitis, the main aspects of examination include the following. First, a complete blood count is necessary, which helps to determine if there is an increase in white blood cells and to assess the proportion of various types of white blood cells; this is a basic test. The second examination is an electroencephalogram (EEG), if the EEG shows abnormalities, it may suggest a diagnosis of encephalitis. The third examination involves cranial magnetic resonance imaging (MRI). If the encephalitis is severe, the MRI can reveal lesions, which also suggests a diagnosis of encephalitis. The fourth examination is invasive, involving a lumbar puncture. This test allows for the analysis of cerebrospinal fluid, assessing whether there is an increase in white blood cells and proteins in the fluid, which plays an important role in the diagnosis of encephalitis. In summary, diagnosing encephalitis necessitates a complete blood count, cranial MRI, analysis of cerebrospinal fluid, and a comprehensive EEG examination.

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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

1min 6sec

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What is checked for encephalitis?

The examination items for encephalitis mainly include, first, some basic hematological tests. These include routine blood tests, liver and kidney function tests, electrolytes, etc., to understand the status of the patient's white blood cells and whether there is any damage to liver and kidney functions. It is also necessary to test for cardiac enzymes, as some viruses can also affect the heart. Second, an EEG is required. Abnormal EEG patterns, such as increased diffuseness, can be observed in encephalitis, which is important for accurate diagnosis. Third, further examinations like lumbar puncture and cerebrospinal fluid tests are needed. The main focus in cerebrospinal fluid is to see if there is an increase in white blood cells and to check if there are any changes in protein and sugar levels in the fluid. This has great reference value for diagnosing whether it is encephalitis and what type of encephalitis it might be. Fourth, a cranial MRI can be performed to clearly identify if there are any organic lesions in the brain.