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Induction and Clinical Scoring of Chronic-Relapsing Experimental Autoimmune Encephalomyelitis
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Induction and Clinical Scoring of Chronic-Relapsing Experimental Autoimmune Encephalomyelitis

Published on: July 4, 2007

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Infectious and autoantibody-associated encephalitis: clinical features and long-term outcome

Sekhar C Pillai1, Yael Hacohen2, Esther Tantsis1

  • 1Neuroimmunology Group, Institute of Neuroscience and Muscle Research at the Kids Research Institute, Children's Hospital at Westmead, University of Sydney, Australia; TY Nelson Department of Neurology and Neurosurgery and.

Pediatrics
|March 25, 2015
PubMed

Insights

Pediatric encephalitis classification revealed immune-mediated/autoantibody-associated forms are common. Early recognition and treatment of these and other encephalitis types are crucial for better patient outcomes.

Area of Science:

  • Pediatric Neurology
  • Neuroimmunology
  • Infectious Diseases

Background:

  • Pediatric encephalitis presents with diverse causes, clinical features, and prognoses.
  • Classifying encephalitis is crucial for targeted treatment and improved outcomes.

Purpose of the Study:

  • To classify and characterize infectious, immune-mediated/autoantibody-associated, and unknown forms of pediatric encephalitis.
  • To determine the relative frequencies, clinical/radiologic phenotypes, and long-term outcomes of different encephalitis types.

Main Methods:

  • Retrospective analysis of 164 Australian children with encephalitis using consensus definitions.
  • Clinical and radiologic phenotyping blinded to etiology; archived sera tested for specific autoantibodies.
  • Long-term outcomes assessed via telephone interviews using the Liverpool Outcome Score.

Main Results:

  • Immune-mediated/autoantibody-associated encephalitis accounted for 34% of cases; infectious encephalitis for 30%.
  • Key subgroups included acute disseminated encephalomyelitis (21%), enterovirus (12%), and N-methyl-D-aspartate receptor antibody (6%).
  • Abnormal outcomes occurred in 49% of patients, with herpes simplex virus and unknown forms having the worst prognoses.

Conclusions:

  • Defined clinical and radiologic phenotypes for infectious and immune-mediated/autoantibody-associated encephalitis in children.
  • Immune-mediated/autoantibody-associated encephalitis is a frequent and critical diagnosis requiring prompt recognition and management.
  • Status epilepticus, MRI diffusion restriction, and ICU admission were associated with poorer outcomes.
Abstract

Keywords:
MRIautoantibodyencephalitisinfectionoutcome

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