Signs and Symptoms to Identify Encephalitis Caused by Hand, Foot, and Mouth Disease

Hand, foot, and mouth disease (HFMD) is a common acute infectious illness primarily caused by enteroviruses, with Enterovirus 71 (EV-A71) and Coxsackievirus A16 being the most frequent culprits. While most cases present with mild symptoms such as fever and rash, the disease can sometimes progress to serious neurological complications, including encephalitis.

Neurological Symptoms Indicating Encephalitis

When the central nervous system becomes involved, the condition can rapidly worsen. Common neurological signs include lethargy, irritability, persistent headaches, vomiting, and altered mental status such as confusion or delirium. In more severe cases, patients may experience seizures, tremors, myoclonus (sudden muscle jerks), nystagmus (involuntary eye movement), and difficulties with coordination and balance.

Physical Examination Findings

During a clinical evaluation, healthcare providers may observe positive meningeal signs, including neck stiffness or Brudzinski's sign. Additionally, diminished or absent tendon reflexes may be noted, along with the presence of Babinski's sign, which indicates an upper motor neuron lesion.

Muscle Weakness and Paralysis

Another alarming symptom is the development of acute flaccid paralysis, which refers to a sudden loss of muscle tone and strength. This condition mimics poliomyelitis and requires immediate medical attention. Seizures may also occur, especially in young children, further signaling potential brain involvement.

Importance of Early Detection

Recognizing these symptoms early is crucial for prompt treatment and better outcomes. If a patient with HFMD begins to show any of these neurological signs, urgent medical evaluation is necessary to rule out or confirm encephalitis and begin appropriate care.