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Encephalitis in Children

What is encephalitis in children?

Illustration of the nervous system
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Encephalitis is a term that means inflammation of the brain. The inflammation causes the brain to swell. This leads to changes in the child's nervous system that include mental confusion, changes in mental status (sometimes even coma), and seizures. Meningitis often happens at the same time as encephalitis. Meningitis is inflammation of the membranes that surround the brain and spinal cord. Meningitis can also happen without encephalitis.

What causes encephalitis in a child?

The cause of encephalitis depends on the season, the area of the country where you live, and what your child is exposed to. Researchers think that viruses are the leading cause of encephalitis.

Children are vaccinated against many viruses, including measles, mumps, rubella, and chickenpox. This has greatly lowered the rate of encephalitis from these diseases. But other viruses can cause encephalitis. These include herpes simplex virus, West Nile virus, and rabies.

Encephalitis can also happen after a bacterial infection such as Lyme disease, tuberculosis, or syphilis. It can also happen after an infection by parasites, such as toxoplasmosis.

Another cause of encephalitis is an autoimmune reaction. This is when the body's own immune system attacks the brain tissues. For example, an antibody made against a protein called an NMDA receptor may cause encephalitis. This may sometimes be triggered by a tumor.

What are the symptoms of encephalitis in a child?

Encephalitis often happens after a viral illness such as an upper respiratory infection, or a digestive problem such as diarrhea, nausea, or vomiting. The following are the most common symptoms of encephalitis. Symptoms may occur a bit different in each child. They can include:

  • Fever

  • Headache or bulging of the soft spots on a baby's head (fontanelles)

  • Sensitivity to light

  • Neck stiffness

  • Sleepiness or lethargy

  • Increased irritability

  • Seizures

  • Skin rashes

  • Difficulty talking and speech changes

  • Changes in alertness, or confusion or hallucinations

  • Loss of energy

  • Loss of appetite

  • Unsteady gait

  • Nausea and vomiting

The symptoms of encephalitis can be like other health conditions. Make sure your child sees his or her healthcare provider for a diagnosis.

How is encephalitis diagnosed in a child?

Your child's healthcare provider will take a complete health history of your child, including his or her vaccination history. The provider may also ask if your child has recently had a cold, other respiratory illness, or a digestive. The provider may ask if the child has recently had a tick bite, been around pets or other animals, or has traveled to certain areas of the country.

Your child may also have tests, such as:

  • MRI.  This test uses a combination of large magnets, radio waves, and a computer to make detailed images of the brain, spinal cord, and other body structures and organs.

  • CT scan.  This test uses X-rays and computer technology to make detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.

  • Blood tests. These may include a test for the NMDA receptor antibody and other antibodies.

  • Urine and stool tests.

  • Sputum culture. This test is done on phlegm (sputum) that your child cough up from the lungs and into the mouth.

  • Electroencephalogram (EEG).  This test records the brain's electrical activity through electrodes attached to the scalp.

  • Spinal tap (lumbar puncture). This test looks at the fluid (cerebral spinal fluid) around your child's brain and spinal cord. The healthcare provider puts a special needle into the lower back. He or she measures the pressure in the spinal canal and brain. The provider also removes a small amount of the fluid and sends it to a lab. The lab looks for an infection or other problems.

  • Brain biopsy.  In rare cases, your child may need a biopsy of affected brain tissue. The healthcare provider removes a small sample for diagnosis.

How is encephalitis treated in a child?

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.

The key to treating encephalitis is finding it early and getting treatment right away. A child with encephalitis needs to stay in the hospital where he or she can be closely watched.

The goal of treatment is to reduce the swelling in the head and to prevent complications. Your child may need to take medicines to stop the infection and control seizures or fever. In severe cases, your child may need to use a breathing machine (ventilator).

As your child recovers, he or she may need physical, occupational, or speech therapy. This will help your child regain muscle strength, speech skills, or both.

The healthcare team will tell you how to best care for your child at home. Your child will likely need regular checkups with the healthcare provider after he or she gets home from the hospital.

Online Medical Reviewer: Sather, Rita, RN
Online Medical Reviewer: Shelat, Amit, MD
Date Last Reviewed: 5/1/2017
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