Title : Clinical profile and long-term outcome of pediatric autoimmune encephalitis: A single center study in a tertiary care hospital in South India
Abstract:
Introduction: Autoimmune Encephalitis (AIE) is closely associated with antibodies against neuronal cell-surface proteins, receptors, and ion channels. However, some forms of disorder have no known antibody presently. In children neurological manifestations are prominent initial presentation as compared to behavioral or psychiatric symptoms. Early diagnosis and prompt treatment leads to improved outcomes with reduced relapses.
Aim & Objectives: The aim of this study was to analyze the clinical profile of patients with definitive or suspected AIE and evaluate the long-term outcomes after receiving treatment.
Materials and methods: A retrospective analysis of AIE patients admitted in the center from January 2021-January 2023 was performed.
Results: Data pertaining to 21 children with AIE were analyzed. 71% had definitive diagnosis of AIE. The mean age of onset was 7 years (1.5-10 years). The initial symptoms were seizures (83%), altered sensorium (76%), involuntary movements/ cognitive decline (52%) & behavioral disturbances (41%). The most common clinical presentation was acute encephalitic syndrome (70%). Only 1 had delta brush pattern in EEG. Brain MRI was suggestive of encephalitis in 65% children. Autoimmune panel was positive in 70% children. 23% were HSV triggered. First line immunotherapy given to most children was Methyl prednisolone and IVIG (70%). 65% were refractory to first line therapy. Average duration of recovery was 90 days. 76% recovered without morbidity. No deaths were re
Conclulsion: This study highlights the increasing incidence of HSV triggered AIE and the need for early initiation of second line therapy in non-responders to ensure better outcome.
Audience Take Away Notes:
- Spectrum of autoimmune encephalitis in exclusive pediatric population with emphasis on long term outcome
- Treatment protocol and outcome scores measurement
