Acute Encephalitis Syndrome in Children: A Contemporary Clinical Approach

This is the authors' abstract. We don't add key points for this paper.

Review ARticleraised intracranial pressure.Core investigations include complete blood count (CBC), glucose, electrolytes, liver and renal function, appropriate body fluid cultures, malaria testing where relevant, and lumbar puncture (LP) when safe.Routine cerebrospinal fluid (CSF) evaluation should include cell count, protein, glucose with paired blood glucose, Gram stain/culture, and targeted polymerase chain reaction (PCR) or serology.Magnetic resonance imaging (MRI) with contrast is preferred to computed tomography (CT) for etiological characterization.Electroencephalography (EEG) is important for seizures, depressed conscious level, or when nonconvulsive status is suspected.Lumbar puncture should be deferred or preceded by neuroimaging when there are major features suggesting raised intracranial pressure or mass effect, significant focal deficits, abnormal pupils, substantial thrombocytopenia/bleeding risk, or local infection.A normal early MRI or CSF does not exclude encephalitis when clinical suspicion remains high. Management: Treat Time-critical Diagnoses FirstManagement should prioritize the treatment of time-critical diagnoses, as summarized in Table 2. Autoimmune encephAlitis: the modern considerAtionAnti-NMDAR encephalitis may resemble viral AES, and viral infection may precede or coexist with autoimmune disease.