Testing & diagnosis for encephalitis in children

The first step in treating your child is forming an accurate diagnosis. Many children come to our Neurology team after they’ve been brought to the emergency room because they’ve had changes in their cognition and/or behavior and a fever, with or without seizures. We’ll take a complete medical history of your child, including her immunization history, and ask whether she has been involved in any activities or been anywhere where she may have been exposed to viruses known to cause encephalitis. Your child’s doctor may also ask if your child has recently:

  • had a cold or other respiratory illness, or a gastrointestinal illness
  • had a tick bite
  • been around pets or other animals
  • traveled to certain areas of the country or outside of the country

This information can provide clues as to what might be causing your child’s symptoms. Some of the procedures we use to diagnose encephalitis include:

  • a CT scan of the brain, to make sure that the symptoms aren’t caused by another cause. This diagnostic test uses x-rays and computer technology to produce detailed, cross-sectional images.
  • a lumbar puncture (spinal tap) to take a small sample of spinal fluid to look for infections, like bacteria and viruses
  • an electroencephalogram (EEG) to see if your child is having subtle underlying seizures - small seizures in her brain that may not be obvious just by looking at her. This is a painless procedure that records the brain's continuous, electrical activity using stickers attached to the scalp that measure electrical activity.
  • magnetic resonance imaging (MRI) to look at detailed images that can show inflammation in the brain.
  • blood, urine and stool tests to check for indications of infection
  • In extremely rare cases, we may recommend that we take a sample of your child’s inflamed brain tissue through a small biopsy. The sample will be studied under the microscope by a pathologist to see whether the underlying cause can be found, and this may help guide treatment decisions for your child.

After we complete all necessary tests, our experts meet to review and discuss what they have learned about your child's condition. Then we’ll meet with you and your family to discuss the results and the best treatment options. You’re always encouraged to ask any questions you have.