How is encephalitis diagnosed?

Written by Zhang Hui
Neurology
Updated on September 02, 2024
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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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How is encephalitis in children diagnosed?

If a child presents with fever, headache, nausea, vomiting, or even convulsions and seizures, it is necessary to be vigilant about the possibility of encephalitis. It is advised to seek medical attention in pediatrics or neurology to conduct a thorough examination. First, an MRI of the brain should be carried out to observe if there are any abnormal signals in the meninges or any damage within the brain substance. Second, cerebrospinal fluid analysis via lumbar puncture is essential for diagnosing encephalitis, as encephalitis patients often show significant abnormalities in cell count and biochemistry of the cerebrospinal fluid, allowing for the identification of different types of infections. Third, an electroencephalogram (EEG) is conducted. While EEG specificity is not high, an affected cerebral cortex in encephalitis patients will show abnormal slow waves. Fourth, routine tests such as a complete blood count should be performed; an elevated blood count can indirectly indicate a potential infection in the patient.

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Written by Zhang Hui
Neurology
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Does encephalitis cause a runny nose?

Encephalitis can potentially cause a runny nose, as it is mainly caused by viral infections. These infections not only invade brain cells, leading to symptoms such as fever, headache, nausea, vomiting, and even seizures related to the nervous system, but can also affect the respiratory tract. If these viruses accumulate in the respiratory tract, particularly in the nasal mucosa, they will definitely cause symptoms such as a runny nose, cough, expectoration, and sore throat. Therefore, it is evident that patients with encephalitis can exhibit symptoms of upper respiratory tract infections. Moreover, some patients initially present with respiratory symptoms, such as a runny nose, before the viruses enter and infect the brain cells. Patients with encephalitis must receive timely treatment, primarily symptomatic treatment to prevent complications, along with antiviral medication for targeted treatment. Most patients have a good prognosis.

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Written by Zhang Hui
Neurology
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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.

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Written by Zhang Hui
Neurology
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Does encephalitis require hospitalization?

The severity of encephalitis can vary greatly; it is generally caused by viral infection. Among these viruses, Herpes Simplex Virus (HSV) is particularly dangerous. Encephalitis caused by HSV can be very severe, with symptoms including high fever, headache, nausea, vomiting, and other serious manifestations. Some patients may even experience seizures, coma, cognitive decline, and changes in mood and behavior. This type of encephalitis is very severe and definitely requires hospitalization. Typically, hospitalization lasts about 2 to 3 weeks, and proper antiviral treatment is necessary. Additionally, there are other forms of encephalitis caused by different viruses that are relatively milder and may even have a certain degree of self-healing properties. Generally, resting well, drinking plenty of water, and consuming fresh vegetables and fruits can lead to recovery. Therefore, whether hospitalization is necessary for encephalitis depends on the severity of the condition and the assessment of which virus has caused the infection. It cannot be generalized.

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Written by Zhang Hui
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Symptoms of encephalitis vomiting

Patients with encephalitis often experience vomiting, and some even have projectile vomiting. This is mainly because patients with encephalitis experience a significant increase in intracranial pressure, which leads to severe vomiting. Additionally, patients may also have noticeable fever, headaches, and can display swelling of the optic disc. In such cases, it is necessary to promptly administer sufficient antiviral medications to the patient, as well as some medications to dehydrate and reduce intracranial pressure. If necessary, corticosteroids can also be used as an adjunct treatment. With aggressive treatment, some patients do recover well. (Please administer medication under the guidance of a professional physician.)