Does encephalitis require hospitalization?

Written by Zhang Hui
Neurology
Updated on September 24, 2024
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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.

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Written by Tang Li Li
Neurology
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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 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 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
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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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What tests are conducted for encephalitis?

First, it is generally necessary to conduct an EEG test. This test is very convenient and non-invasive for patients. If significant slow waves are detected, encephalitis cannot be ruled out. Secondly, an MRI of the brain should be performed. If the viral encephalitis is severe, abnormal signals can be observed in areas such as the frontal lobe, temporal lobe, and hippocampus on the MRI, which are of great diagnostic reference value. Thirdly, lumbar puncture is also very important. It allows for a direct observation of the color of the cerebrospinal fluid, to monitor the pressure of the brain fluid, and to test the cerebrospinal fluid for cell count, protein, sugar, and chloride levels. These tests are very important for the diagnosis and differential diagnosis of encephalitis.