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 Zhang Hui
Neurology
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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.

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Written by Zhang Hui
Neurology
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How to check for encephalitis?

To check for encephalitis, the main aspects of examination include the following. First, a complete blood count is necessary, which helps to determine if there is an increase in white blood cells and to assess the proportion of various types of white blood cells; this is a basic test. The second examination is an electroencephalogram (EEG), if the EEG shows abnormalities, it may suggest a diagnosis of encephalitis. The third examination involves cranial magnetic resonance imaging (MRI). If the encephalitis is severe, the MRI can reveal lesions, which also suggests a diagnosis of encephalitis. The fourth examination is invasive, involving a lumbar puncture. This test allows for the analysis of cerebrospinal fluid, assessing whether there is an increase in white blood cells and proteins in the fluid, which plays an important role in the diagnosis of encephalitis. In summary, diagnosing encephalitis necessitates a complete blood count, cranial MRI, analysis of cerebrospinal fluid, and a comprehensive EEG examination.

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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 Zhang Hui
Neurology
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Viral encephalitis and bacterial encephalitis differences

There are significant differences between viral encephalitis and bacterial encephalitis in clinical settings. Firstly, their clinical symptoms differ; the fever in viral encephalitis is generally lower than that in bacterial encephalitis, where there may be widespread chills and persistent high fever. From another perspective, laboratory tests also help differentiate the two. In viral encephalitis, a routine blood test shows no increase in white blood cells, mainly an increase in the proportion of lymphocytes. In contrast, bacterial encephalitis is characterized by a significant increase in white blood cells, which aids in distinguishing the two. Furthermore, an essential diagnostic tool is the lumbar puncture, through which cerebrospinal fluid can be tested. In viral encephalitis, the white blood cell count in the cerebrospinal fluid is slightly increased; in bacterial encephalitis, it is significantly increased. The cerebrospinal fluid in viral encephalitis has a slight increase in protein content with no significant change in chloride levels; however, in bacterial encephalitis, the protein content in the cerebrospinal fluid is notably higher, and there is a significant decrease in chloride levels.

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Written by Zhang Hui
Neurology
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Does encephalitis require hospitalization?

The severity of encephalitis can vary greatly; it is generally caused by viral infection. Among these viruses, Herpes Simplex Virus (HSV) is particularly dangerous. Encephalitis caused by HSV can be very severe, with symptoms including high fever, headache, nausea, vomiting, and other serious manifestations. Some patients may even experience seizures, coma, cognitive decline, and changes in mood and behavior. This type of encephalitis is very severe and definitely requires hospitalization. Typically, hospitalization lasts about 2 to 3 weeks, and proper antiviral treatment is necessary. Additionally, there are other forms of encephalitis caused by different viruses that are relatively milder and may even have a certain degree of self-healing properties. Generally, resting well, drinking plenty of water, and consuming fresh vegetables and fruits can lead to recovery. Therefore, whether hospitalization is necessary for encephalitis depends on the severity of the condition and the assessment of which virus has caused the infection. It cannot be generalized.