How is encephalitis diagnosed?

Written by Zhang Hui
Neurology
Updated on September 02, 2024
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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.

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Written by Zhang Hui
Neurology
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Does encephalitis cause fever?

If the patient's encephalitis is caused by a viral infection, they usually exhibit fever, often a high fever with temperatures reaching above 39°C, accompanied by significant symptoms such as headache, nausea, and vomiting. Some patients may also experience cognitive dysfunction, epileptic seizures, and psychiatric symptoms. Therefore, it is crucial to seek medical attention promptly, complete examinations such as electroencephalography, lumbar puncture, and cranial magnetic resonance imaging, and timely apply effective antiviral medications. It should be noted that some encephalitis is caused by autoimmune reactions, referred to as autoimmune encephalitis, which is relatively rare clinically. This type of encephalitis generally does not present with fever. (Please use medications under the guidance of a doctor.)

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Written by Li Jiao Yan
Neonatology
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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.

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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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How to prevent encephalitis

Most cases of encephalitis are transmitted through close contact, such as children playing with toys together. It is possible for them to ingest viruses through their hands, which then enter the bloodstream from the stomach and attack the brain. Some cases of encephalitis are also transmitted through the respiratory tract, mainly through droplets. Therefore, in order to prevent encephalitis, it is crucial to maintain hand hygiene, wash hands frequently, and avoid crowded places to prevent respiratory transmission. In addition, to prevent encephalitis, it is important to improve one's physical condition and exercise regularly, as a strong body is less susceptible to viral infections. Finally, it is essential to ensure adequate nutrition for encephalitis prevention, including sufficient daily intake of carbohydrates and dietary fiber, as well as vitamins C and folate, which are crucial for enhancing the body's resistance.

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Written by Zhang Hui
Neurology
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After-effects of encephalitis

Some more serious types of encephalitis may leave sequelae. For example, common ones like herpes simplex viral encephalitis and epidemic encephalitis B. A minority of patients may suffer from certain degrees of sequelae, which typically include the following aspects. Firstly, some patients may experience secondary epileptic seizures, which present with loss of consciousness, limb convulsions, incontinence, and frothing at the mouth. These symptoms might require long-term oral medication for epilepsy. Secondly, another consequence of encephalitis is cognitive impairment in patients, characterized by significant reductions in computational ability, memory, and executive function. Additionally, some forms of encephalitis might leave patients with psychiatric symptoms, such as speaking incoherently.