Encephalitis

Encephalitis is an inflammation of the brain, of the cerebral parenchyma. It is an infectious disease caused, in most cases, by a virus.

It is a disease that must be differentiated from meningitis (inflammation of the membranes that cover the brain: the meninges)

Causes

In our area, encephalitis are caused, mostly by viruses. The most frequently implicated viruses are:

• Herpes virus type 1: causes the most serious encephalitis and is also the cause of cold sores.
• Varicella virus
• Flu virus
• Enterovirus
• HIV: is the virus that causes AIDS
• Epstein-Barr virus: the virus that causes mononucloesis or kissing disease.

There are other diseases not so frequent in our country that can also cause inflammation of the brain such as: Lyme disease, toxoplasmosis, ricketsiosis or tuberculosis. Thanks to routine childhood vaccination, many viruses that caused encephalitis in the past are now virtually eradicated or a very rare cause of encephalitis: measles, mumps, and rubella.

Symptoms

The first symptoms are very nonspecific in the child: fever, malaise, runny nose, cough or gastroenteritis (depending on the type of virus that has infected the child). If the virus inflames the brain, the child will start to have a severe headache, a stiff neck, nausea and vomiting, drowsiness, confusion, irritability, or hallucinations. In some cases the child may have a seizure. What most attracts the attention of parents is a change in the child's "character": he goes from being a very active child to being completely still or asleep, or he is characterized by extreme irritability or crying. They are symptoms similar to meningitis, the difference is that in encephalitis, the symptoms appear in a more progressive way, not so abrupt. The deterioration of the child can be observed, even, in several days. Most cases of encephalitis are mild and its symptoms are short-lived. However, it is possible to develop severe encephalitis that can even endanger the life of the child.

Diagnosis

To diagnose encephalitis, a cerebrospinal fluid analysis (using a lumbar puncture) and a blood test must be performed. A lumbar puncture is a procedure that involves inserting a needle into the lumbar area (the lower part of the back) very thin to extract a small amount of cerebrospinal fluid. The sample is sent to the laboratory to detect the presence of viruses or bacteria. It is also possible that the pediatrician order some diagnostic imaging test, such as an MRI and / or a CT scan in order to identify possible signs of brain inflammation.

Treatment

The child with suspected encephalitis should be admitted to a hospital for proper monitoring and follow-up. As one of the most common and serious causes is herpes virus encephalitis, you will always be treated with acyclovir urgently. Once the causative agent of encephalitis has been identified, the treatment will either be discontinued or the treatment will be changed. It can be a serious infection that can cause permanent sequelae in the child.