Addressing Severe Headache Challenges: The Role of High- Dose Methylprednisolone in Pediatric Viral Encephalitis

Viral encephalitis (VE) is an inflammation of the brain parenchyma caused by a viral infection. It presents with a range of neurological symptoms, including headache, fever, stiff neck stiff, altered consciousness, seizures along with motor deficits. The incidence of VE is estimated to be 5-10 cases per 100,000 people annually, with a mortality rate of 10-20%(1). The most common viral causes of VE include herpes simplex virus (HSV), varicella-zoster virus (VZV), Epstein-Barr virus (EBV), and human enterovirus (HEV) but have also other rare viral causes. The frequency of specific agents varies according to geographic location, season, patient immunological status, and viral genetic mutations over time(2).

Amongst the symptoms headaches are a prominent symptom in VE, affecting majority of the patients. The headache is typically severe, diffuse, and non-pulsatile, and may be accompanied by nausea, vomiting, and photophobia. The severity of the headache can vary depending on the underlying viral etiology and the extent of brain inflammation and can be symptomatically treated by
medication(3). Corticosteroids, such as methylprednisolone, has been experimentally used in the treatment of VE, particularly in cases with severe headache and neurological deficits having a visible effect on its symptoms. Methylprednisolone is a potent anti-inflammatory agent that can help reduce swelling and inflammation in the brain, thereby alleviating neurological symptoms (4). Click here to read more

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