Can encephalitis recur?

Written by Tang Li Li
Neurology
Updated on October 27, 2024
00:00
00:00

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.

Other Voices

doctor image
home-news-image
Written by Yan Xin Liang
Pediatrics
39sec home-news-image

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.

doctor image
home-news-image
Written by Zhang Hui
Neurology
1min 6sec home-news-image

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.

doctor image
home-news-image
Written by Zhang Hui
Neurology
1min 25sec home-news-image

How is encephalitis diagnosed?

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.

doctor image
home-news-image
Written by Zhang Hui
Neurology
1min 5sec home-news-image

Can encephalitis be cured?

The viruses that cause encephalitis are relatively common. Whether they can be cured depends mainly on the type of virus causing the encephalitis, the severity of the condition, and whether the treatment is timely. Generally, most cases of encephalitis, such as those caused by enterovirus infections, tend to self-heal to a certain extent. The focus should be on care to prevent complications, electrolyte disorders, overheating, and to provide appropriate antiviral treatment. Most patients can be cured. However, there are also some more dangerous types of encephalitis, such as encephalitis caused by the type B encephalitis virus, which can rapidly lead to disturbances in consciousness, seizures, and even respiratory involvement, resulting in respiratory failure. This type of encephalitis is more severe and can leave significant sequelae even if successfully treated. For herpes simplex virus encephalitis, as long as the initial symptoms are not particularly severe and antiviral medications are used in a timely manner, the prognosis is still good.

doctor image
home-news-image
Written by Tang Li Li
Neurology
1min 42sec home-news-image

How is encephalitis diagnosed?

The diagnosis of encephalitis relies on the following aspects. First, it is based on clinical manifestations. If the patient clearly exhibits symptoms such as headache, fever, nausea, vomiting, and signs of increased intracranial pressure, and physical examination shows positive signs of meningeal irritation, then there is a high suspicion of encephalitis. Second, various auxiliary tests can be conducted. Initially non-invasive tests such as electroencephalograms (EEG) and magnetic resonance imaging (MRI) of the skull can be completed. If the MRI reveals significant abnormalities, such as abnormal signals in the frontal and temporal lobes including the hippocampus, then viral encephalitis should be highly suspected. If the EEG shows moderate abnormalities or increased slow waves, it also indicates damage to the cerebral cortex, serving as an indirect indicator of encephalitis. Third, a lumbar puncture can be performed to ascertain any abnormalities in the cerebrospinal fluid (CSF) routine and biochemical tests. If the cell count is elevated beyond ten times the normal value, an inflammatory infection is considered. There is often a minor to moderate increase in protein. The levels of glucose and chloride may decrease in bacterial and tuberculous encephalitis, while they are generally normal in viral encephalitis.