J Nicholas Brenton1, Howard P Goodkin2. 1. Division of Pediatric Neurology, Department of Neurology, University of Virginia, Charlottesville, Virginia. Electronic address: jnb8h@virginia.edu. 2. Division of Pediatric Neurology, Department of Neurology, University of Virginia, Charlottesville, Virginia.
Abstract
BACKGROUND: The differential diagnosis of encephalitis in childhood is vast, and evaluation for an etiology is often unrevealing. Encephalitis by way of autoimmunity has long been suspected, as in cases of acute disseminated encephalomyelitis; however, researchers have only recently reported evidence of antibody-mediated immune dysregulation resulting in clinical encephalitis. MAIN FINDINGS: These pathologic autoantibodies, aimed at specific neuronal targets, can result in a broad spectrum of symptoms including psychosis, catatonia, behavioral changes, memory loss, autonomic dysregulation, seizures, and abnormal movements. Autoimmune encephalitis in childhood is often quite different from adult-onset autoimmune encephalitis in clinical presentation, frequency of tumor association, and ultimate prognosis. As many of the autoimmune encephalitides are sensitive to immunotherapy, prompt diagnosis and initiation of appropriate treatment are paramount. CONCLUSIONS: Here we review the currently recognized antibody-mediated encephalitides of childhood and will provide a framework for diagnosis and treatment considerations.
BACKGROUND: The differential diagnosis of encephalitis in childhood is vast, and evaluation for an etiology is often unrevealing. Encephalitis by way of autoimmunity has long been suspected, as in cases of acute disseminated encephalomyelitis; however, researchers have only recently reported evidence of antibody-mediated immune dysregulation resulting in clinical encephalitis. MAIN FINDINGS: These pathologic autoantibodies, aimed at specific neuronal targets, can result in a broad spectrum of symptoms including psychosis, catatonia, behavioral changes, memory loss, autonomic dysregulation, seizures, and abnormal movements. Autoimmune encephalitis in childhood is often quite different from adult-onset autoimmune encephalitis in clinical presentation, frequency of tumor association, and ultimate prognosis. As many of the autoimmune encephalitides are sensitive to immunotherapy, prompt diagnosis and initiation of appropriate treatment are paramount. CONCLUSIONS: Here we review the currently recognized antibody-mediated encephalitides of childhood and will provide a framework for diagnosis and treatment considerations.
Authors: Achille Marino; Francesco Canonico; Raffaella Maria Pinzani; Massimo Andreotti; Tiziana Varisco; Alberto Maria Cappellari Journal: Turk Pediatri Ars Date: 2020-12-16
Authors: Dirkje de Blauw; Andrea H L Bruning; Katja C Wolthers; Anne-Marie van Wermeskerken; Maarten H Biezeveld; Joanne G Wildenbeest; Dasja Pajkrt Journal: Pediatr Infect Dis J Date: 2022-04-01 Impact factor: 3.806