Encephalitis (inflammation of the brain) in children


What is it about ?

Encephalitis is an acute (that is, sudden) inflammation of brain tissue. Since the meninges are closely related to brain tissue, they usually become inflamed as well (meningitis).

Usually the cause of the disease is an infection caused by a virus, and more rarely by bacteria. The possible causes are:

  • herpes simplex virus,
  • the virus that causes chickenpox (varicella zoster virus),
  • the virus that is transmitted after a tick bite (tick-borne encephalitis),
  • bacteria called borrelia which are transmitted after a tick bite (Lyme disease),
  • Epstein-Barr virus (trigger of infectious mononucleosis),
  • viruses that cause respiratory infections, such as adenoviruses, influenza viruses,
  • etc.

Encephalitis can also be an autoimmune condition. The body then produces antibodies directed against the brain tissue, causing an inflammatory reaction.

How to recognize it?

On the one hand, there are symptoms linked to the infection, and on the other hand, signs of damage to the brain tissue.

The infection usually causes mild flu-like symptoms, such as sudden headaches, joint and muscle pain, fatigue, and fever.

Damage to brain tissue can cause the following symptoms:

  • decreased state of consciousness or confusion,
  • abnormal drowsiness,
  • abnormal behavior (irritability and wailing),
  • difficulty speaking or running,
  • convulsions,
  • paralysis,
  • etc.

When the meninges are affected simultaneously (meningoencephalitis), there is stiffness in the neck. This stiffness prevents the child from bringing the chin to the chest. But it is also possible that this sign is totally absent.

How is the diagnosis made?

The diagnosis of encephalitis is mainly based on complaints and signs indicating a malfunction of brain tissue.

As this is a serious and complex illness, the doctor will refer you to the hospital for further examinations. Usually a lumbar puncture and a blood test will be done. The lumbar puncture and cerebrospinal fluid analysis can see if it is a viral or bacterial infection.

With some types of encephalitis, specific antibodies are also found in the blood. If the disease has already progressed for several days, abnormalities can also be detected on a CT scan of the brain.

What can your doctor do?

Encephalitis is usually treated in the hospital. Bed rest is necessary. If possible, the cause is also treated there.

In cases of viral encephalitis, antiviral drugs are usually started, although the cause is not yet known for sure. The chance of recovery is greatest when you fight the herpes virus early enough.

Antibiotics are indicated when a bacterial germ is the cause of encephalitis.

Autoimmune encephalitis is treated with cortisone, which helps suppress the immune response.

Source

Foreign clinical practice guide ‘Childhood encephalitis’ (2000), updated on 30.11.2016 and adapted to the Belgian context on 22.11.2019 – ebpracticenet