What are the symptoms of encephalitis?

Written by Zhang Hui
Neurology
Updated on September 16, 2024
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The clinical manifestations of encephalitis are complex and varied, primarily caused by infections from pathogens such as viruses and bacteria. There are numerous clinical symptoms, with fever being quite common; patients generally exhibit significant fevers, which can reach up to 38 degrees Celsius or even as high as 40 degrees Celsius. Headache is also a very common clinical manifestation of encephalitis, with some patients experiencing severe headaches accompanied by pronounced nausea and vomiting. Additionally, some patients may exhibit psychiatric symptoms, which mainly include incoherent speech, hallucinations, and failing to recognize family members. Some patients may experience cognitive impairments, such as diminished memory, and significant deficits in computational and judgment abilities. In severe cases, some patients may have epileptic seizures, characterized by convulsions of the limbs. Overall, the manifestations of encephalitis are diverse and can range from simple fever and headache to severe conditions such as psychiatric symptoms, cognitive impairments, and epilepsy.

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Written by Yan Xin Liang
Pediatrics
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Symptoms of baby encephalitis

Generally speaking, the symptoms of encephalitis in babies usually start with fever. Encephalitis is an infectious disease, and the majority of cases present with fever, which could be either high or low. Next is vomiting. Since small infants cannot express headache, they usually manifest symptoms through crying, irritability, and restlessness. Additionally, there might be lethargy and malaise. Some may experience seizures, and others might have stiff neck, characterized by rigidity of the neck and changes in muscle tone of the limbs, among other symptoms. These are all symptoms of encephalitis.

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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 Li Li
Neurology
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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
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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.

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Written by Zhang Hui
Neurology
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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.