Diagnosis and Management of Acute Encephalitis in Children

Overview

Journal Indian J Pediatr

Specialty Pediatrics

Date 2018 Sep 21

PMID 30232787

Citations 7

Authors

Satinder Aneja

Suvasini Sharma

Affiliations

Soon will be listed here.

Abstract

Acute encephalitis is a common cause of death and neurodevelopmental problems in children. The causative agents are numerous including infectious agents such as viruses, bacteria, mycobacteria and protozoa; para-infectious and immune mediated disorders such as acute disseminated encephalomyelitis (ADEM) and autoimmune encephalitis, especially the recently described anti-NMDA receptor encephalitis. Also, many viral associated encephalopathies such as acute necrotizing encephalopathy can mimic the presentation of acute encephalitis. In this article, authors describe the approach to the diagnosis and management of acute encephalitis in children.

Citing Articles

Pediatric non-congenital central nervous system infections: role of imaging in the emergency department.

Lazarte-Rantes C, Sinti-Ycochea M, Guillen-Pinto D Pediatr Radiol. 2025; .

PMID: 40019500 DOI: 10.1007/s00247-025-06193-7.

The role of immunoglobulin in cerebrospinal fluid on the differential diagnosis of autoimmune encephalitis and viral encephalitis in children.

Hu X, Cheng S BMC Pediatr. 2024; 24(1):386.

PMID: 38851704 PMC: 11161917. DOI: 10.1186/s12887-024-04824-w.

Effect of Pediatric Rehabilitation on Children With Viral Encephalitis: A Case Report.

Biyani A, Sharath V, Varma T Cureus. 2024; 16(3):e57239.

PMID: 38686226 PMC: 11056810. DOI: 10.7759/cureus.57239.

Role of physical therapy intervention in acute disseminated encephalomyelitis.

Parmar S, Deshpande C, Kadam D BMJ Case Rep. 2024; 17(4).

PMID: 38589237 PMC: 11015239. DOI: 10.1136/bcr-2023-257339.

Early Prediction of Epilepsy after Encephalitis in Childhood Based on EEG and Clinical Features.

Sun X, Zhao J, Guo C, Zhu X Emerg Med Int. 2023; 2023:8862598.

PMID: 37485251 PMC: 10359137. DOI: 10.1155/2023/8862598.

References

Shrivastava A, Kumar A, Thomas J, Laserson K, Bhushan G, Carter M . Association of acute toxic encephalopathy with litchi consumption in an outbreak in Muzaffarpur, India, 2014: a case-control study. Lancet Glob Health. 2017; 5(4):e458-e466. DOI: 10.1016/S2214-109X(17)30035-9. View

Caramello P, Canta F, Balbiano R, Lipani F, Ariaudo S, De Agostini M . Role of intravenous immunoglobulin administration in Japanese encephalitis. Clin Infect Dis. 2006; 43(12):1620-1. DOI: 10.1086/509644. View

Britton P, Blyth C, Macartney K, Dale R, Li-Kim-Moy J, Khandaker G . The Spectrum and Burden of Influenza-Associated Neurological Disease in Children: Combined Encephalitis and Influenza Sentinel Site Surveillance From Australia, 2013-2015. Clin Infect Dis. 2017; 65(4):653-660. DOI: 10.1093/cid/cix412. View

Kneen R, Michael B, Menson E, Mehta B, Easton A, Hemingway C . Management of suspected viral encephalitis in children - Association of British Neurologists and British Paediatric Allergy, Immunology and Infection Group national guidelines. J Infect. 2011; 64(5):449-77. DOI: 10.1016/j.jinf.2011.11.013. View

Ooi M, Wong S, Lewthwaite P, Cardosa M, Solomon T . Clinical features, diagnosis, and management of enterovirus 71. Lancet Neurol. 2010; 9(11):1097-105. DOI: 10.1016/S1474-4422(10)70209-X. View

Kumar R, Basu A, Sinha S, Das M, Tripathi P, Jain A . Role of oral Minocycline in acute encephalitis syndrome in India - a randomized controlled trial. BMC Infect Dis. 2016; 16:67. PMC: 4743094. DOI: 10.1186/s12879-016-1385-6. View

Kumar R, Tripathi P, Baranwal M, Singh S, Tripathi S, Banerjee G . Randomized, controlled trial of oral ribavirin for Japanese encephalitis in children in Uttar Pradesh, India. Clin Infect Dis. 2009; 48(4):400-6. DOI: 10.1086/596309. View

Sharma S, Mishra D, Aneja S, Kumar R, Jain A, Vashishtha V . Consensus guidelines on evaluation and management of suspected acute viral encephalitis in children in India. Indian Pediatr. 2012; 49(11):897-910. DOI: 10.1007/s13312-012-0216-0. View

Carod-Artal F, Wichmann O, Farrar J, Gascon J . Neurological complications of dengue virus infection. Lancet Neurol. 2013; 12(9):906-919. DOI: 10.1016/S1474-4422(13)70150-9. View

10.

Martinez-Torres F, Menon S, Pritsch M, Victor N, Jenetzky E, Jensen K . Protocol for German trial of Acyclovir and corticosteroids in Herpes-simplex-virus-encephalitis (GACHE): a multicenter, multinational, randomized, double-blind, placebo-controlled German, Austrian and Dutch trial [ISRCTN45122933]. BMC Neurol. 2008; 8:40. PMC: 2605746. DOI: 10.1186/1471-2377-8-40. View

11.

Rotbart H, Webster A . Treatment of potentially life-threatening enterovirus infections with pleconaril. Clin Infect Dis. 2001; 32(2):228-35. DOI: 10.1086/318452. View

12.

Mittal M, Thangaraj J, Rose W, Verghese V, Kumar C, Mittal M . Scrub Typhus as a Cause of Acute Encephalitis Syndrome, Gorakhpur, Uttar Pradesh, India. Emerg Infect Dis. 2017; 23(8):1414-1416. PMC: 5547812. DOI: 10.3201/eid2308.170025. View

13.

Iro M, Sadarangani M, Absoud M, Chong W, Clark C, Easton A . ImmunoglobuliN in the Treatment of Encephalitis (IgNiTE): protocol for a multicentre randomised controlled trial. BMJ Open. 2016; 6(11):e012356. PMC: 5129051. DOI: 10.1136/bmjopen-2016-012356. View

14.

Abbas A, Garg A, Jain R, Mazibrada G, Jacob S . Extreme delta brushes and BIRDs in the EEG of anti-NMDA-receptor encephalitis. Pract Neurol. 2016; 16(4):326-7. DOI: 10.1136/practneurol-2016-001380. View

15.

Kamei S, Sekizawa T, Shiota H, Mizutani T, Itoyama Y, Takasu T . Evaluation of combination therapy using aciclovir and corticosteroid in adult patients with herpes simplex virus encephalitis. J Neurol Neurosurg Psychiatry. 2005; 76(11):1544-9. PMC: 1739396. DOI: 10.1136/jnnp.2004.049676. View

16.

Graus F, Titulaer M, Balu R, Benseler S, Bien C, Cellucci T . A clinical approach to diagnosis of autoimmune encephalitis. Lancet Neurol. 2016; 15(4):391-404. PMC: 5066574. DOI: 10.1016/S1474-4422(15)00401-9. View

17.

Mohammad S, Soe S, Pillai S, Nosadini M, Barnes E, Gill D . Etiological associations and outcome predictors of acute electroencephalography in childhood encephalitis. Clin Neurophysiol. 2016; 127(10):3217-24. DOI: 10.1016/j.clinph.2016.07.014. View

18.

Karmarkar S, Aneja S, Khare S, Saini A, Seth A, Chauhan B . A study of acute febrile encephalopathy with special reference to viral etiology. Indian J Pediatr. 2008; 75(8):801-5. DOI: 10.1007/s12098-008-0150-2. View

19.

Mizuguchi M, Yamanouchi H, Ichiyama T, Shiomi M . Acute encephalopathy associated with influenza and other viral infections. Acta Neurol Scand. 2007; 115(4 Suppl):45-56. DOI: 10.1111/j.1600-0404.2007.00809.x. View

20.

Hoke Jr C, Vaughn D, Nisalak A, Intralawan P, Poolsuppasit S, Jongsawas V . Effect of high-dose dexamethasone on the outcome of acute encephalitis due to Japanese encephalitis virus. J Infect Dis. 1992; 165(4):631-7. DOI: 10.1093/infdis/165.4.631. View