Can encephalitis be cured?

Written by Zhang Hui
Neurology
Updated on September 10, 2024
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Encephalitis is divided into many types. If it is a simple herpes virus encephalitis infection, this is a rather dangerous type of encephalitis. Before the advent of antiviral drugs, the mortality rate of this type of encephalitis was very high. Now, with improvements in diagnostic and treatment levels and the development of antiviral drugs, the prognosis for this type of encephalitis is generally quite good. As long as the initial condition is not particularly severe, the patient is not in a coma, or there is no obvious continuous epileptic state, the prognosis is still good, and many patients do not have any residual sequelae. However, if the initial condition is quite severe, there is usually some degree of cognitive impairment or weakness in the limbs. Other viral encephalitides, such as those caused by Coxsackie viruses and adenoviruses, tend to have milder symptoms, mainly fever, headache, nausea, and vomiting. These types of encephalitis can mostly be cured with appropriate symptomatic treatment and antiviral therapy.

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How is encephalitis diagnosed?

The diagnosis of encephalitis relies on the following aspects. First, it is based on clinical manifestations. If the patient clearly exhibits symptoms such as headache, fever, nausea, vomiting, and signs of increased intracranial pressure, and physical examination shows positive signs of meningeal irritation, then there is a high suspicion of encephalitis. Second, various auxiliary tests can be conducted. Initially non-invasive tests such as electroencephalograms (EEG) and magnetic resonance imaging (MRI) of the skull can be completed. If the MRI reveals significant abnormalities, such as abnormal signals in the frontal and temporal lobes including the hippocampus, then viral encephalitis should be highly suspected. If the EEG shows moderate abnormalities or increased slow waves, it also indicates damage to the cerebral cortex, serving as an indirect indicator of encephalitis. Third, a lumbar puncture can be performed to ascertain any abnormalities in the cerebrospinal fluid (CSF) routine and biochemical tests. If the cell count is elevated beyond ten times the normal value, an inflammatory infection is considered. There is often a minor to moderate increase in protein. The levels of glucose and chloride may decrease in bacterial and tuberculous encephalitis, while they are generally normal in viral encephalitis.

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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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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 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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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.