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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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 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.

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Written by Tang Li Li
Neurology
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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
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Does encephalitis cause fever?

If the patient's encephalitis is caused by a viral infection, they usually exhibit fever, often a high fever with temperatures reaching above 39°C, accompanied by significant symptoms such as headache, nausea, and vomiting. Some patients may also experience cognitive dysfunction, epileptic seizures, and psychiatric symptoms. Therefore, it is crucial to seek medical attention promptly, complete examinations such as electroencephalography, lumbar puncture, and cranial magnetic resonance imaging, and timely apply effective antiviral medications. It should be noted that some encephalitis is caused by autoimmune reactions, referred to as autoimmune encephalitis, which is relatively rare clinically. This type of encephalitis generally does not present with fever. (Please use medications under the guidance of a doctor.)

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Written by Zhang Hui
Neurology
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Is encephalitis serious?

The severity of encephalitis varies greatly among individuals. Some mild cases of encephalitis, even with some degree of self-healing, do not require special treatment. For example, encephalitis caused by some enteroviruses and respiratory viruses has a very good recovery, and it is only necessary to prevent complications. However, some types of encephalitis are very dangerous and can even threaten the life of the patient. For instance, herpes simplex virus encephalitis can cause necrosis of the cerebral cortex, leading to high fever, headache, nausea, vomiting, and even epileptic seizures, psychiatric symptoms, and a significant increase in intracranial pressure, requiring urgent treatment.