How is encephalitis in children diagnosed?

Written by Tang Li Li
Neurology
Updated on September 11, 2024
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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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Pediatric Encephalitis Examination Items

Encephalitis in children is primarily due to a lowered immune resistance, which leads to infection by certain viruses. These viruses invade the nervous system, causing damage to neurons, resulting in symptoms such as fever, headache, nausea, and vomiting. Generally, the main tests for pediatric encephalitis include hematological tests related to bleeding, primarily involving routine blood tests, C-reactive protein, and erythrocyte sedimentation rate. These indices can reflect the inflammatory conditions inside the patient's body, helping to distinguish between viral and bacterial infections. Another very important auxiliary examination is the electroencephalogram (EEG), where pediatric encephalitis can show mild to moderate abnormalities, which is helpful for accurate diagnosis. The third examination involves performing a lumbar puncture to test the cerebrospinal fluid (CSF) for the levels of white cells, glucose, and chloride, which are crucial for diagnosing encephalitis and differentiating it from other types of encephalitis.

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Written by Tang Bo
Neurology
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How is a brain encephalitis puncture performed?

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
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How to prevent encephalitis

Most cases of encephalitis are transmitted through close contact, such as children playing with toys together. It is possible for them to ingest viruses through their hands, which then enter the bloodstream from the stomach and attack the brain. Some cases of encephalitis are also transmitted through the respiratory tract, mainly through droplets. Therefore, in order to prevent encephalitis, it is crucial to maintain hand hygiene, wash hands frequently, and avoid crowded places to prevent respiratory transmission. In addition, to prevent encephalitis, it is important to improve one's physical condition and exercise regularly, as a strong body is less susceptible to viral infections. Finally, it is essential to ensure adequate nutrition for encephalitis prevention, including sufficient daily intake of carbohydrates and dietary fiber, as well as vitamins C and folate, which are crucial for enhancing the body's resistance.

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Written by Zhang Hui
Neurology
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Is encephalitis hereditary?

Encephalitis is mostly caused by viral infections. For instance, Epidemic B encephalitis is caused by the B encephalitis virus, and herpes simplex encephalitis is caused by the herpes simplex virus. Therefore, encephalitis is not related to genetic mutations and is not hereditary, so there is no need for special concern. It is important to note that some cases of encephalitis are not directly related to viral infections and may be related to autoimmune responses. For example, autoimmune encephalitis can occur in patients experiencing immune system disorder, which may be accompanied by some tumors. A disordered immune system can produce antibodies that attack one's own brain tissue, leading to autoimmune encephalitis. This type of encephalitis also has no genetic tendencies.

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Written by Li Jiao Yan
Neonatology
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What to do with pediatric encephalitis

If a child develops encephalitis, it is definitely recommended that they be hospitalized for treatment. It is necessary to assess their condition and determine the cause of the encephalitis: is it viral? Bacterial? Or caused by other pathogens? If encephalitis occurs, aggressive treatment is certainly required. In such cases, if the child is discharged from the hospital, they must regularly revisit the hospital for follow-up examinations, and the development of the child's nervous system must be monitored, focusing on motor and cognitive development. Regular assessments at the hospital are definitely required.