Is encephalitis serious?

Written by Zhang Hui
Neurology
Updated on March 04, 2025
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The severity of encephalitis varies greatly among individuals. Some mild cases of encephalitis, even with some degree of self-healing, do not require special treatment. For example, encephalitis caused by some enteroviruses and respiratory viruses has a very good recovery, and it is only necessary to prevent complications. However, some types of encephalitis are very dangerous and can even threaten the life of the patient. For instance, herpes simplex virus encephalitis can cause necrosis of the cerebral cortex, leading to high fever, headache, nausea, vomiting, and even epileptic seizures, psychiatric symptoms, and a significant increase in intracranial pressure, requiring urgent treatment.

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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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Is the blood count high in encephalitis?

Not all cases of encephalitis show an increase in blood counts. Elevated blood counts in encephalitis generally occur in bacterial infections, such as the most common pyogenic meningitis. This can cause a significant increase in blood counts, predominantly with neutrophils. Tuberculous meningitis can also show elevated blood counts, but not as prominently as pyogenic meningitis. In cases of viral infection, such as the common herpes simplex virus infection, patients might experience a decrease in blood counts. This is characterized by a reduction in the total number of white blood cells, a lower proportion of neutrophils, and a possible increase in lymphocyte proportion. If the patient has a concurrent lung infection or other bacterial infections at different sites, there might be an increase in blood counts, which can mask the blood abnormalities originally caused by the viral infection.

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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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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.

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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.