Viral Central Nervous System Infections in Children

Your central nervous system (CNS) is your brain and spinal cord. A viral infection can affect one or both of these organs. Infection can result in:

• Meningitis: infection of the meninges, which are the layers of tissue that cover the brain and spinal cord

• Encephalitis: infection of the brain

Viral CNS infections can be very serious.

• The first sign is usually a fever, followed by crankiness, not wanting to eat, headache, neck pain, and sometimes seizure

• Most children recover, but some go into a coma and die

• A few children have permanent complications such as deafness, mental difficulties, seizures, or weakness of an arm or leg

• Doctors do a spinal tap to see if your child has meningitis or encephalitis

• There's usually no specific treatment for a viral infection of the brain or spinal cord

Viral central nervous system infections are caused by many different types of viruses.

Children get these viruses in different ways, for example:

• From their mother as they pass through the birth canal (herpesvirus)

• Bites by infected insects

• Breathing air near someone who has the virus

Symptoms vary by age.

Babies usually have:

• Fever

• Fussiness or crying, even when held or rocked—sometimes with an unusual, high-pitched cry

• Throwing up

• Eating poorly

In some babies, the first sign is a seizure.

Children may have:

• Headache

• Stiff neck

• Fever

• With severe encephalitis, sluggishness and confusion followed by coma and possibly death

With encephalitis caused by herpes simplex virus infection, infants and children may have evidence of infection elsewhere such as a rash of red spots and fluid-filled blisters on the skin, in the mouth, or around the eyes.

To know if your child has meningitis or encephalitis, doctors do:

• A spinal tap

In a spinal tap, the doctor puts a needle into the lower back to draw fluid from around the spinal cord. Sometimes doctors also do:

• EEG (electroencephalogram ) to see your child's brain waves

• MRI (magnetic resonance imaging) and CT (computed tomography) scans of your child’s brain

Doctors may:

• Treat babies in the hospital to keep them warm and give them fluids and medicines for fever or seizures

• Treat a herpes simplex virus infection with an antiviral medicine through your child's vein (IV)

• Sometimes, treat long-lasting brain and nerve damage by giving corticosteroids or other medicines