Understanding Encephalitis in Children During World Encephalitis Day
World Encephalitis Day is commemorated on 22 February 2020. Dr Alvin Ndondo, paediatric neurologist at the Red Cross War Memorial Children’s Hospital, shared the following information regarding Encephalitis:
Encephalitis is inflammation of the brain and usually results in the swelling of the brain tissue itself. The extent of swelling and areas of involvement in the brain can differ from one child to the next.
What are causes of encephalitis in children?
The commonly known causes of encephalitis are virus infections. Other infections can also result in encephalitis, including certain parasites and bacteria. Over the past 10 to 12 years, another emerging cause of encephalitis has been inflammation due to an attack by the body’s own immune system on the brain tissue, called autoimmune encephalitis.
When associated with inflammation of the coverings of the brain, it is called meningo-encephalitis.
What are symptoms of encephalitis in childhood?
Young children can present with non-specific symptoms initially, with or without fever. The following are some of the symptoms that can occur in any combination:
- Headache (with or without vomiting)
- Sensitivity to light
- Unusual irritability
- Sleepiness or loss of consciousness
- Confusion or sudden change in behaviour
- Seizures or abnormal movements
- Difficulty with walking or unsteadiness
Who is at risk for developing encephalitis?
Any child with fever and /or any of the following infections is at risk:
- Respiratory infections (eg. Influenza)
- Gastrointestinal infections with diarrhoea and/or vomiting
- Viral infections eg. Chicken pox, measles, etc.
- Children that have been in contact with other children or adults with the above conditions
- Young children and children with impaired immune systems are at risk of more severe involvement.
What preventative measures can help reduce the risk in a child?
General preventative measures include the following:
- Simple measures to prevent cross-infection (basic hygiene, minimising contact with infected individuals, etc.).
- Making sure that all children are fully immunised against preventable infections.
- Influenza vaccine shots for young children and others at risk, every year before the winter.
Is there treatment for encephalitis?
Most viruses cannot be treated with antimicrobial agents, and most of the treatment is supportive.
It is mostly directed at trying to support the and preserve the brain’s integrity and function. Treating the symptoms, supporting vital bodily functions, managing/ reducing brain swelling, treating any seizures, ensuring adequate supply of essential nutrients and oxygen to the brain, etc. A lot of children end up under intensive care requiring life-support interventions, with prolonged hospital stays. Many of the children with autoimmune encephalitis sub-type can be treated successfully, with generally good outcomes.
What complications can arise as a result of encephalitis?
Some children have milder involvement and recover without significant neurological medical consequence. Many children, however, are not so lucky. They suffer the complications of encephalitis, with variable significance: Developmental deficits, learning disabilities, epilepsy, motor disabilities, and movement disorders. When vital brain functions are compromised, death can result.