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Encephalitis
How is encephalitis caused?
Encephalitis generally falls into two categories: one is infectious inflammation caused by pathogenic infections, and the other is immune inflammation caused by abnormalities in immune mechanisms. Among these, the infectious type is the most common, including viral encephalitis, viral meningitis, tuberculous meningoencephalitis, purulent meningitis, and cryptococcal meningitis, which are associated with infections by viruses, bacteria, Mycobacterium tuberculosis, and Cryptococcus, respectively. Additionally, abnormalities in the immune system often cause autoimmune encephalitis, as well as multiple sclerosis and neuromyelitis optica when involving the brain, and acute disseminated encephalomyelitis, all of which are types of autoimmune encephalitis. The treatment approaches for these two types of encephalitis are different. For pathogen-induced cases, treatment primarily targets the pathogens: antiviral drugs for viral encephalitis, antibiotics for bacterial encephalitis, anti-tubercular therapy involving multiple drugs for Mycobacterium tuberculosis infection, and antifungal drugs, such as amphotericin B, for cryptococcal meningitis. For immune-mediated encephalitis, treatments generally involve immunosuppressants, high-dose corticosteroids, or intravenous immunoglobulins.
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.
Can encephalitis be cured?
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.
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.
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.
How to relieve headache from encephalitis
Encephalitis is mainly divided into viral encephalitis, bacterial encephalitis, and tubercular meningitis, among others. Encephalitis usually causes patients to experience fever, headache, nausea, and vomiting. The cause of headaches includes the pain response due to inflammation stimulating the meninges. Moreover, these infections can cause an increase in intracranial pressure, leading to significant symptoms in patients such as headache, nausea, and vomiting. To alleviate headaches, it is important to actively treat the primary disease. This includes administering antiviral drugs for viral infections, and antibiotics for bacterial infections. If the headache is caused by increased intracranial pressure, it is crucial to actively administer dehydrating agents and drugs that lower intracranial pressure to reduce it, thereby relieving the headache. Additionally, the use of glucocorticoids can be combined to manage the treatment, suppress the inflammatory response, and alleviate pain. If the pain is significant, non-steroidal anti-inflammatory drugs may also be administered to relieve the pain. The treatment of pain in encephalitis is a comprehensive issue that requires addressing the pathogen, dehydration, reduction of intracranial pressure, and symptomatic treatment.
Symptoms of childhood cold and encephalitis
Some common symptoms of encephalitis secondary to a cold in children primarily include fever, usually moderate to high, though some may exhibit low fever. Next, symptoms such as headache, dizziness, primarily around the forehead, crown, or occipital region, may occur. This is followed by vomiting, which is generally more evident after eating or drinking, with some exhibiting persistent vomiting. Additionally, some may experience lethargy, weakness, or even seizures.
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.
How is encephalitis in children treated?
Encephalitis in children is generally treated based on the cause of the infection. It could be caused by viral infections, bacterial infections, or other pathogens. The most basic treatment is definitely to address the cause of the encephalitis. If there are other symptoms such as fever or seizures, symptomatic treatment should be administered based on these symptoms. The treatment plan should be tailored to the specific condition of the child.
How is encephalitis diagnosed?
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.