What tests are conducted for encephalitis?

Written by Zhang Hui
Neurology
Updated on December 05, 2024
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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.

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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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Symptoms of encephalitis in children

Encephalitis in children is generally caused by viral infections, leading to inflammation that naturally results in symptoms like fever. Thus, fever is the most common symptom of pediatric encephalitis, with some body temperatures reaching extremely high levels, even above 40 degrees Celsius. Additionally, patients also experience significant headaches, nausea, and vomiting due to inflammation or increased intracranial pressure. Furthermore, patients often feel discomfort in the occipital and cervical regions, which is a sign of meningeal irritation. If the encephalitis symptoms are very severe, severely affecting the cerebrospinal fluid, the patient may even experience limb paralysis, epileptic seizures, limb convulsions, and frothing at the mouth. Some patients also suddenly exhibit cognitive dysfunction, becoming dull in response, with noticeable impairment in attention, memory, calculation, and judgment abilities. Some children may exhibit psychological symptoms and must receive timely treatment.

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Written by Zhang Hui
Neurology
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What are the symptoms of encephalitis?

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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Neurology
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Encephalitis MRI manifestations

Encephalitis, commonly referred to, is generally viral encephalitis. Herpes simplex viral encephalitis, a type of viral encephalitis, typically shows distinct manifestations in brain MRI scans. For instance, the patient's MRI may reveal high T2 signals in several areas of the cerebral cortex, particularly in the frontal and temporal lobes, and the hippocampus. If there are subsequent hemorrhagic changes, high signals will also appear on T1-weighted images. Additionally, the MRI of encephalitis may display diffusion-weighted imaging with unusually bright signals, and these signals do not follow a vascular distribution, which strongly suggests encephalitis. Patients with encephalitis generally exhibit significant symptoms such as fever, headache, nausea, and vomiting. In severe cases, they may also experience limb paralysis, psychiatric symptoms, and complications like epilepsy.

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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.