How is encephalitis in children treated?

Written by Li Jiao Yan

Neonatology

Updated on September 03, 2024

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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.

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Written by Tang Li Li

Neurology

1min 18sec

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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 Tang Li Li

Neurology

1min 46sec

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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.

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Written by Zhang Hui

Neurology

59sec

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How is encephalitis transmitted?

The commonly mentioned encephalitis is mainly caused by viral infections. There are many types of viruses that can cause encephalitis, including the more severe herpes simplex virus, varicella-zoster virus, etc. There are also some enteroviruses, like Coxsackie virus, and some adenoviruses. Typically, the transmission of encephalitis can occur via the fecal-oral route, where some enteroviruses enter the digestive tract through this route, then from the cells of the digestive tract to the bloodstream, and from there to the brain. Additionally, some viruses are transmitted through blood contact. For instance, if a patient has blisters that rupture and release a large amount of virus, and another person's blood comes into contact with these fluids, transmission can occur via blood. Generally, encephalitis is primarily transmitted through fecal-oral routes and bloodborne transmission.

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Written by Zhang Hui

Neurology

1min 23sec

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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.

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Written by Tang Li Li

Neurology

1min 5sec

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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.