What are the symptoms of encephalitis causing convulsions?

Encephalitis is a common phenomenon in children, especially the convulsions caused by encephalitis, which can have a great impact on their growth and health. Encephalitis in newborns and infants can show symptoms such as fever, severe head pain, nausea, vomiting, whole body convulsions, and even loss of will. Therefore, for these symptoms, we should pay attention to distinguish and understand the symptomatic treatment of these diseases and use medications scientifically.

1. Symptoms and Signs

1. The onset is usually explosive or acute. The acute phase in adults and children is often manifested by fever, severe headache, vomiting, whole body convulsions, impaired consciousness or neck stiffness.

2. There may be a history of upper respiratory tract infection before the onset of the disease. Newborns and infants often have high fever, irritability, drowsiness, dyspnea, jaundice, and may then have convulsions, opisthotonos, and apnea, with very few neurological manifestations. The neonate may have a history of premature birth, birth trauma or prenatal maternal infection before becoming ill. Signs of meningeal irritation may appear in the early stages of physical examination, such as a stiff neck, positive Kernig sign, and positive Brudzinski sign. However, neck stiffness in infants and young children is often not obvious, and is often manifested by a full anterior fontanelle and opisthotonos.

3. Pneumococcal and Haemophilus influenzae infections may cause local brain signs in the early stages, manifested as persistent local brain damage and difficult-to-control epileptic seizures. Later in the course of the disease, there may be cranial nerve disorders, most commonly eye movement disorders, which are most common in patients with pneumococcal meningitis. In addition, there may be impaired consciousness and fundus edema, and brain herniation may sometimes occur due to increased intracranial pressure. During meningitis epidemics, if the disease progresses rapidly, with petechiae or ecchymoses on the skin and mucous membranes at onset and rapid enlargement, and shock occurs, meningococcal meningitis should be considered.

2. Medication

1. Purulent meningitis is a medical emergency. Treatment should first be based on maintaining blood pressure and correcting shock. According to age and seasonal characteristics, effective antibiotics that can easily penetrate the blood-cerebrospinal fluid barrier should be selected in a targeted manner, and then antimicrobial drugs should be adjusted according to the results of bacterial culture and drug sensitivity tests.

2. In the past few decades, the three common pathogens of purulent meningitis were generally sensitive to penicillin, but in recent years, the sensitivity of these bacteria to penicillin has decreased, especially influenza bacilli, which can produce β-lactamases that are resistant to ampicillin (ampicillin) and penicillin. Many literature reports show that isolated pneumococcal and meningococcal strains are also relatively or highly resistant to penicillin. Fortunately, third-generation cephalosporins have obvious effects on purulent meningitis caused by these pathogens. However, cephalosporin treatment is ineffective for some highly resistant strains and vancomycin is required.

3. In children and adults, third-generation cephalosporins are the first choice for treating three common types of purulent meningitis. Among them, ceftriaxone (ceftriaxone), ceftriaxone and cefuroxime (cefuroxime) are more effective. For patients suspected of having Listeria meningitis, ampicillin is added. For those who are severely allergic to penicillin or have previously used cephalosporins, chloramphenicol is a more appropriate choice.