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[Acute viral meningitis and encephalitis in children]
1Département de pédiatrie et INSERM U 56, Hôpital de Bicêtre, Le Kremlin-Bicêtre, France.
Insights
Viral meningitis and encephalitis in children present with varied symptoms. Early diagnosis and treatments like acyclovir for herpes encephalitis improve outcomes, with prevention focusing on immunisation.
Area of Science:
- Neurology
- Pediatrics
- Infectious Diseases
Context:
- Viral meningitis and encephalitis are significant neurological conditions in infants and children.
- These infections present with a spectrum of clinical severity.
- Understanding the underlying mechanisms, including CNS cellular destruction and immune responses, is crucial.
Purpose:
- To outline the clinical and diagnostic features of viral encephalitis in children.
- To discuss management strategies for viral encephalitis and meningitis.
- To highlight preventative measures and therapeutic advancements.
Summary:
- Clinical and electroencephalogram (EEG) findings in herpes encephalitis are often distinctive.
- Cerebrospinal fluid (CSF) analysis aids in differential diagnosis.
- Management involves anti-edema therapy, seizure control, and specific antiviral treatments like acyclovir for herpes simplex virus.
- Passive immunization is key for preventing post-infectious encephalitis.
Impact:
- Prognosis for herpes encephalitis has significantly improved with the introduction of acyclovir.
- Mortality rates for post-infectious encephalitis in France are low (under 5%).
- Sequelae rates for post-infectious encephalitis are also reduced (under 20%), indicating effective management and prevention strategies.
Abstract:
Both viral meningitis and encephalitis in infants and children give clinical features of various severity. The mechanism of viral encephalitis varies from CNS cellular destruction, immune or oedematous process. The clinical and EEG features of herpes encephalitis in the child are usually well recognizable. CSF characteristics are important for differential diagnosis. Management therapy includes anti-oedema treatment, prevention or cure of seizures. Passive immunisation against rubella, rubeola and measles is the best prevention therapy for post-infectious encephalitis. Herpes encephalitis prognosis has improved with acyclovir therapy. In France, mortality due to post-infectious encephalitis is estimated below 5% and sequellae below 20%.