When Your Child Has Encephalitis
Encephalitis is inflammation of the brain. It is a rare condition that is most often caused by a viral infection. A mild case may not be recognized. It may be diagnosed as a viral illness with a headache. But severe cases are serious and can be life-threatening. If you think your child has encephalitis, call the healthcare provider right away. Your child will need medical care right away. Treatment can decrease your child’s chances of long-term problems and help with recovery.
What causes encephalitis?
Bacteria can cause encephalitis. But the most common cause is viruses. These include viruses that cause the stomach flu, chickenpox, fever blisters, or other childhood viral infections. In rare cases, it can also occur in children who have caught certain infections from an insect or animal bite or scratch. Mosquito- and tick-borne viruses can also cause encephalitis. These viruses can cause infections such as West Nile, La Crosse, St. Louis, western equine, and eastern equine encephalitis. Mosquitoes transfer the virus from animals, such as birds, chipmunks, or horses, to humans. Symptoms may appear from a few days to a few weeks after exposure. In people with weak immune systems, it can also be caused by fungi and parasites.
In some cases, encephalitis may occur a few weeks after an infection. This happens because the immune system, while attacking the virus, also attacks the brain tissue by mistake.
Encephalitis can also be caused by autoimmune diseases that attack the brain. Certain immune system diseases can cause encephalitis when your body is fighting cancer. Sometimes autoimmune encephalitis develops without a specific trigger.
Often the cause is not known.
What are the symptoms of encephalitis?
In mild cases, symptoms may seem like the flu. They include:
In moderate to severe cases, symptoms may include:
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High fever
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Headache
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Muscle weakness, loss of feeling in some parts of the body
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Trouble walking or using arms
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Convulsions or seizures
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Confusion, memory loss, personality changes
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Trouble communicating
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Speech, hearing, or vision problems
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Nausea or vomiting
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Trouble swallowing
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Sleepiness
How is encephalitis diagnosed?
In severe cases, your child will be admitted to the hospital. They will likely see a healthcare provider who specializes in nervous system problems in children (pediatric neurologist). The neurologist examines your child. They also ask about your child’s health history and symptoms. Your child may also have tests such as:
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Spinal tap (lumbar puncture). This test checks the health of the fluid around the brain and spinal cord. This fluid is called cerebrospinal fluid (CSF). During the test, the skin on the lower back is numbed with a local anesthetic. Then, a needle is put into the spinal canal and a sample of CSF is taken. The CSF is checked in a lab for signs of infection, inflammation, or other diseases. The pressure of the CSF can also be measured.
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MRI or CT scan. These are done to make detailed pictures of the brain and check for swelling. Both tests are painless. Fluid called contrast dye may be used. It makes the brain easier to see on the scans. MRI is the preferred test. But CT may be done if your child can't have an MRI. Or it may be done if an MRI is not available right away. Medicine can be given to help your child stay calm and lie still during the tests.
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Blood tests. These check for certain viruses, infections, or other conditions that may have similar symptoms.
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EEG (electroencephalogram). This test measures the brain’s electrical activity.
How is encephalitis treated?
A child with a severe case will need to be in the hospital. They will be given fluids and medicines (antibiotics and antiviral medicines) through an IV (intravenous) line. If your child is having seizures, they may be given medicines for this (anticonvulsants). Some more unusual forms of encephalitis may need treatment with IV steroids or immunoglobulin. Your child may be watched in the hospital until symptoms improve. Overall treatment time will vary for each child. This is based on the severity and cause of the brain inflammation. The healthcare provider will speak with you about other forms of treatment if they are needed.
What are the long-term concerns?
Children can recover fully. And most do. But in some cases, children may have ongoing (chronic) nervous system problems. This can include trouble with learning, reasoning, speech, or movement. Regular follow-up with the healthcare provider may be advised, depending on your child’s condition. Supportive care may be prescribed to help your child if needed. This can include speech, physical, or occupational therapy.