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Viral Central Nervous System Infections in Children


The Manual's Editorial Staff

Last full review/revision Dec 2019| Content last modified Dec 2019
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What are viral central nervous system (CNS) infections?

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 a few 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

What causes viral CNS infections in children?

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

What are the symptoms of a viral CNS infection in children?

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 a rash of red spots and fluid-filled blisters on the skin or in the eyes or mouth.

Are there any complications of a viral CNS infection?

Some babies and children have brain and nerve problems after the infection. They may have:

  • Weakness in an arm or leg

  • Loss of sight or hearing

  • Changes in the way they act

  • Learning or behavior problems

  • Seizures that come and go

Sometimes these problems go away, but they can be permanent.

How will doctors know if my child has a viral CNS infection?

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 to see your child's brain waves

  • MRI and CT scans of your child’s brain

How do doctors treat viral CNS infections in children?

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

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