After-effects of encephalitis

Written by Zhang Hui
Neurology
Updated on November 12, 2024
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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.

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Written by Tang Bo
Neurology
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How is a brain encephalitis puncture performed?

The encephalitis you mentioned is considered a central nervous system infection. In this case, a definitive diagnosis requires a lumbar puncture, which you referred to as a puncture. The lumbar puncture requires the patient to be in the lateral recumbent position, then the puncture is performed in the interspaces between L1-L3 or L4-L5 on the back to collect cerebrospinal fluid and conduct tests. This also allows for the examination of pathogens and pressure measurements. After the lumbar puncture, the patient needs to lie flat for six hours with a pillow removed to prevent headaches due to low cranial pressure.

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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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What tests are done for pediatric encephalitis?

Some auxiliary examinations are very necessary for pediatric encephalitis, which help in the diagnosis and differential diagnosis of encephalitis. The main tests generally include the following: First, an electroencephalogram (EEG), which is the most commonly used examination. It is safe, non-invasive, and relatively accurate. Children with encephalitis will show light to moderate abnormalities in the EEG. Combined with the patient's history of fever and headache, it has important clinical significance for the diagnosis of encephalitis. The second important examination is cranial magnetic resonance imaging (MRI). If the encephalitis is severe, pathological changes in the cerebrospinal fluid can be seen on MRI. The third very important examination is lumbar puncture. Lumbar puncture can mainly determine the pressure of the cerebrospinal fluid, the color of the cerebrospinal fluid, and analyze the levels of white blood cells, glucose, and chloride in the cerebrospinal fluid. This is crucial for diagnosing encephalitis and excluding other types of encephalitis.

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Written by Tang Li Li
Neurology
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Can encephalitis recur?

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.

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Written by Zhang Hui
Neurology
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Does encephalitis cause a runny nose?

Encephalitis can potentially cause a runny nose, as it is mainly caused by viral infections. These infections not only invade brain cells, leading to symptoms such as fever, headache, nausea, vomiting, and even seizures related to the nervous system, but can also affect the respiratory tract. If these viruses accumulate in the respiratory tract, particularly in the nasal mucosa, they will definitely cause symptoms such as a runny nose, cough, expectoration, and sore throat. Therefore, it is evident that patients with encephalitis can exhibit symptoms of upper respiratory tract infections. Moreover, some patients initially present with respiratory symptoms, such as a runny nose, before the viruses enter and infect the brain cells. Patients with encephalitis must receive timely treatment, primarily symptomatic treatment to prevent complications, along with antiviral medication for targeted treatment. Most patients have a good prognosis.